--- title: Clustering Sentences (non-hierachical) keywords: fastai sidebar: home_sidebar nb_path: "topic_clustering.ipynb" ---
{% raw %}
{% endraw %} {% raw %}
import pandas as pd

df = pd.read_csv("downloads/40k_balanced_pm_acl.csv").sample(frac=0.5)
sentences = list(df["text"])
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Sentence Transformers

{% raw %}
from sentence_transformers import SentenceTransformer, util

print("Encode the corpus ... get a coffee in the meantime")
model = SentenceTransformer('sentence-transformers/all-mpnet-base-v2')
embeddings = model.encode(sentences, batch_size=64, show_progress_bar=True, convert_to_tensor=True)
---------------------------------------------------------------------------
ModuleNotFoundError                       Traceback (most recent call last)
<ipython-input-1-d778fc617d7b> in <module>
----> 1 from sentence_transformers import SentenceTransformer, util
      2 
      3 print("Encode the corpus ... get a coffee in the meantime")
      4 model = SentenceTransformer('sentence-transformers/all-mpnet-base-v2')
      5 embeddings = model.encode(sentences, batch_size=64, show_progress_bar=True, convert_to_tensor=True)

ModuleNotFoundError: No module named 'sentence_transformers'
{% endraw %} {% raw %}
len(embeddings)
21070
{% endraw %}

Agglomerative Clustering

{% raw %}
from sklearn.cluster import AgglomerativeClustering

import numpy as np

embeddings = embeddings.cpu()

# Normalize the embeddings to unit length
corpus_embeddings = embeddings /  np.linalg.norm(embeddings, axis=1, keepdims=True)

# Perform kmean clustering
clustering_model = AgglomerativeClustering(n_clusters=None, distance_threshold=1.5) #, affinity='cosine', linkage='average', distance_threshold=0.4)
clustering_model.fit(corpus_embeddings)
cluster_assignment = clustering_model.labels_
{% endraw %} {% raw %}
clustered_sentences = {}
for sentence_id, cluster_id in enumerate(cluster_assignment):
    if cluster_id not in clustered_sentences:
        clustered_sentences[cluster_id] = []

    clustered_sentences[cluster_id].append(sentences[sentence_id])

for i, cluster in clustered_sentences.items():
    print("Cluster ", i+1)
    print(cluster)
    print("\n")
Cluster  249
['Acquired resistance to molecular target inhibitors is a severe problem in cancer therapy .', 'Resistance to chemotherapy drugs is a serious therapeutic problem and its underlying molecular mechanisms are complex .', 'Despite considerable progress over the last 25 years in the systemic therapy of lung cancer , intrinsic and acquired resistance to chemotherapeutic agents and radiation remains a vexing problem .', 'Resistance to chemotherapy remains a serious problem in the successful treatment of gastric and esophageal cancers .', 'Drug resistance remains a serious problem in leukemia therapy .', 'However , radioresistance remains a serious concern that prevents the efficacy of esophageal squamous cell carcinoma ( ESCC ) radiotherapy .', 'However , as in the case of most targeted anti-cancer therapies , the emergence of drug resistance is a serious concern .', 'Resistance to chemotherapy remains a serious problem inhibiting the successful treatment of advanced esophageal cancer .', 'Drug resistance continues to be a serious problem in cancer therapy .', 'Development of resistance to therapy continues to be a serious clinical problem in lung cancer management .', 'Colorectal cancer ( CRC ) resistance to fluoropyrimidines and other inhibitors of thymidylate synthase ( TS ) is a serious clinical problem often associated with increased intracellular levels of TS .', 'Resistance of cancer cells to chemotherapeutics and emerging targeted drugs is a devastating problem in the treatment of cancer patients .', 'Resistance to 5-fluorouracil ( 5-FU ) in patients with gastric cancer is a serious therapeutic problem and major efforts are underway to understand the underlying mechanisms .']


Cluster  58
['Domestic violence is a serious public health and human rights concern and an on-going challenge for nursing .', 'Workplace violence is becoming increasingly recognized as a serious problem in health care settings .', 'Nursing management is regarded as a key issue in the reduction of coercion and containment', 'Workplace violence , a dangerous and complex occupational hazard in the modern health care work environment , presents challenges for nurses , other health care employees , management , labor unions , and regulators .', 'Violence against nurses is a serious problem that can affect negatively the quality of nursing care .', 'Workplace incivility is a common problem in nursing, and novice nurses are particularly vulnerable to incivility', 'As a serious social problem , nurses will need to assess and intervene with families where this type of family violence occurs .', 'Work-related violence is a major public health problem ; however , there is a serious deficiency in the knowledge of risk factors for this problem .', 'Recent evidence describes workplace incivility as a serious concern in the healthcare setting worldwide .', 'Workplace violence is a serious and multidimensional problem that adversely affects professional and personal lives of employees .', 'Workplace violence is a serious occupational problem among nurses in emergency departments .', 'Violence in the workplace is a serious public health problem .']


Cluster  86
['A total of 150 patients were randomly allocated into three groups of 50 each, digital (D), introducer (I), and tongue depressor (TD).', 'In addition to the tasks of pre-digestion , buffering of food acids , protection and remineralisation of tooth substance and moistening of the oral mucosa , saliva also plays an important role in wound healing , and a reduced flow rate represents a serious problem for patients .', 'Significant reductions were obtained in the mean gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and mucosal recession (MR) values at both 6 and 12\u2009months postoperatively compared to baseline for both treatment procedures (P\u2009<\u20090.', 'The purpose of the study at primary endpoint is to compare early (occurring within 30\xa0days of surgery) and late (occurring during the follow-up) postoperative complications between both groups The purpose of the study at secondary endpoint is to compare intraoperative and postoperative events between experimental and control groups in terms of operating time, first oral tolerance day, first flatus and faeces, length of hospital stay and orocecal transit; comparing rates of gastrointestinal life quality and comparing mortality rates between both groups.', 'Six-month postoperative mean mouth opening (MMO) increase was 13.', 'In a 6-month study, 100 participants with primary and secondary BMS were divided into two groups-fluoxetine and control (placebo) and examined by the dentist and the neurologist.', 'The etiology of TMD is not clear and considering certain clinical features including dental occlusion are not justified in the evidence-based TMD practice for making irreversible occlusal treatment decisions.', 'A potential drawback of salivary gland transfer is the treatment delay associated with the surgery , and its complications .', 'Findings suggest the absence of relevant effects of invisible orthodontic retainers on sMMA in healthy individuals during the short-term period.', 'Three hundred patients were included in the study (150 in the control group, 150 in the gum group).', 'This study fails to demonstrate whether or not adjunctive cTBS to right inferior parietal lobule could significantly alleviate FRS.']


Cluster  165
['Subjects in all 3 experimental groups, when compared with control subjects, demonstrated improvements in the follow-up test in terms of ability to use inhalers correctly (P < .', 'During a placebo-controlled trial of an inhaled levodopa formulation, CVT-301, in PD patients with ≥2 h/d of OFF time, spirometry was performed by American Thoracic Society (ATS) guidelines at screening and throughout the 4-week treatment period.', 'We assessed the patients diagnosed with achalasia who underwent LHD as their first treatment from 1992 to 2016.', 'Inhalant abuse is a serious public health problem throughout the world .', 'Verbal counselling plus audio feedback and verbal counselling plus audio and visual feedbacks groups had 45/50 (90%) and 37/50 (74%) subjects respectively, having correct inhalation flow (inhaling at between 3 to 7\xa0seconds).', 'A major drawback of inhaled iloprost , however , is the short half-life and hemodynamic effect ( 30 to 60 min ) demanding multiple daily inhalation manoeuvres ( up to nine times ) .', "The educational interventions developed were successful in behavioral modification and beneficial beyond usual care in terms of improving proper use of inhalers and understanding of physicians' instructions.", 'Inhalant dependence is a serious health problem in adolescent subjects and is associated with high comorbidity of other substance dependence , psychiatric disorder , and externalizing spectrum disorder .', 'Our study supports previous findings that atenolol is at least as effective as propranolol for treatment of IHs and poses less risk of bronchospasm.', 'Twelve patients with intratumoral fiducials were included and asked to perform three consecutive 30-second inhale BHs on each of three measurement days.', 'A prospective randomised trial was performed on all soldiers diagnosed with ISSNHL in our institution from 1 January 2007 to 31 December 2016.']


Cluster  1692
['To determine the independent association between changes in BMI and change in utility-based HRQOL.', 'We correlated changes in BMI to prognosis and frequency of hospitalizations in patients who were hospitalized for decompensated HF.', 'The relationship between body mass index (BMI) and mortality remains controversial.', "Controlling for participants' BMI and pretest scores, the intervention significantly improved posttest FMS in the experimental group compared to the comparison group.", 'Based on our results, we postulate that MPA derivates influence post-transplant BMI and potentially also body fat content.', 'Adverse bleeding events happened more frequently among individuals with, or at risk of, a low body mass index (BMI) than others.', 'To describe cardiometabolic risk in HSCT/TBI survivors and identify anthropometric measurements of adiposity representative of cardiometabolic risks in HSCT/TBI survivors.', 'Losing body weight in HF patients was a significant predictive factor of the frequency of hospitalizations and increased mortality.', 'For both men and women, BMI and overall mortality showed a U-shaped association, with the lowest mortality rate among those with a BMI of 25-27.', 'Logistic regression analysis indicated a correlation between low Body Mass Index (BMI) and extended progression-free survival (PFS).']


Cluster  514
["politics , economy , medicine -RRB- or a latent cluster in a topic model . Fong 's approach does not extend to the VIA-reading ( in Jackendoff 's terminology ) of sentences like Example ( 3 )", 'A main shortcoming of using ROUGE-1 is that the generated sentences are compared only to a finite set of human labeled ground truth which obviously does not capture all possible sentences that one can generate', 'We believe that it is much easier for a person to separate a set of texts into two piles -LRB- the relevant texts and the irrelevant texts -RRB- than to generate detailed text annotations for a domain . data sparseness', "Another point to bear in mind is that the documents we 're webscraping are designed for sighted users , which means that one can not assume that the modalities of text and data they take the bag-of-words ( BOW ) assumption without considering the fact that an email thread is a multi-party , asynchronous conversation", 'Here we see that BLEU scores increase rapidly with small amounts of data , but they taper off and flatten at much larger amounts . they are designed to find only full sentences', "A problem with Graves ' task is that it requires memory searching after stimulus presentation , probably reducing the predicted number of items processed .", 'A problem with the NDRT is that reading comprehension test items can be answered correctly without reading the associated passage .', 'This suggests that using all the words from the text spans -LRB- i.e. , EDUs -RRB- produces sparse models . it involves a good deal of human effort to research on a specific data set and summarize the rules', 'There are three types of supervised/semisupervised data used in the experiments . summarization of multimodal documents : no existing system is able to incorporate the non-text portions of a document ( e.g. , information graphics , images ) into the overall summary', 'The text with the largest number of instructions is selected as the reference . no labeled training data in the target domain', 'If such a system is used by wider audiences , then statistically driven techniques might be employed gradually , probably the loss and distortion of semantic information']


Cluster  174
['Cancer is a serious clinical problem to the health care system .', 'Cancers have killed millions of people in human history and are still posing a serious health problem worldwide .', 'This malignant tumor poses a serious public health problem in many countries , especially in Southeast Asia and North Africa where the recorded incidence are highest .', 'Cancer continues to be a severe global health problem and the leading cause of death worldwide .', 'Cancer in general , continues to be a serious health problem for the population of Pasto .', 'Cancer is a life-threatening global problem with high incidence rates .', 'CC is the most common cancer among women from Roraima , and represents a serious public health problem in Roraima .', 'Considering the fact that an upward tendency has recently been observed in morbidity due to this type of cancer , this is a serious medical problem .', 'Cancer remains a serious healthcare problem despite significant improvements in early detection and treatment approaches in the past few decades .', 'Various types of cancer are nowadays a serious medical and social problem and a great challenge for modern medicine .', 'Cancer is a serious public health problem worldwide responsible for more than 70 % of all deaths globally .', 'Nowadays , cancer has become a serious public health problem .', 'Cancer treatment remains a serious problem worldwide .', 'Cancer is a life-threatening concern worldwide .', 'In spite of advances in cancer diagnosis and treatment , cancer remains a serious problem for most societies .', 'Cancer is a serious public issue problem worldwide .', 'Cancer is a serious health problem as well as a scientific challenge .', 'The number of cancer cases worldwide in terms of morbidity and mortality is a serious concern , despite the presence of therapeutic interventions and supportive care .', 'Cancer is a life-threatening condition and also one of the biggest challenges facing human health and the medical community .']


Cluster  1410
['This study was based on a sample cohort database released by the Korean National Health Insurance Service.', 'Retrospective observational study was conducted between January 1, 2005, and December 31, 2014.', 'This observational, cross-sectional study was conducted between September 2013 and March\xa02014.', 'Data from our institutional database was reviewed from 1992 to 2017.', 'A cross-sectional and observational study was conducted during a period of 3\xa0months (April-June 2017).', 'Longitudinal observational study of a cohort recruited between 2008 and 2011.', 'Data analysis from a longitudinal observational study (N\u2009=\u20092591).', 'An observational analysis of the longitudinally linked California Office of Statewide Health Planning and Development database was conducted from 1995 to 2009.', 'Cross-sectional observational study through an online survey in Spain, based on a non-probability sample (n=315).', 'Between 2006 and 2015, consecutive adult SE episodes were prospectively recorded in a registry.', 'An observational study which took place between May 2010 and July 2013.', "This is a sequential comparison of 'pre' (December 2015 to May 2016) and 'post' (June 2016 to December 2016) implementation outcomes.", 'This was a prospective, observational study from January 2013 through December 2014.', 'A prospective database over a 15-year period (April 1999 to March 2014) was analysed.']


Cluster  60
['Standardbred geldings (n\xa0=\xa015) aged 3-11\xa0years were used.', 'The boot caused significant decreases in lamellar temperatures compared with untreated control limbs in all horses.', 'Twenty horses of different breeds with a median age of eight years (interquartile range 6.', 'Efficacy analyses were based on 39 horses that completed the trial.', 'In healthy and endotoxaemic horses, the sleeve style ice boot significantly decreased mean skin (7.', 'Evaluate skin and lamellar cooling after application of the ice sleeve in healthy horses, and the same horses during an endotoxaemia model.', 'To assess the feasibility of <sup>18</sup> F-NaF PET in the equine distal limb and explore possible applications in the horse in comparison with other imaging modalities.', 'Complete regression was achieved in eight horses (40%) and partial regression in two horses (10%).', 'Twenty-five of 26 horses had adequate contrast enhancement of their distal limb.']


Cluster  1041
['Cadmium ( Cd ) contaminated in rice grains is a serious problem because most Asians consume rice on a daily basis .', 'The contamination of rice paddies with heavy metals has become a serious concern due to their high toxicity to human health .', 'Cadmium ( Cd ) pollution in soil is a serious problem affecting environmental safety and human health , and the majority of Cd in human body comes from edible vegetables , especially leafy vegetables .', 'Soil cadmium ( Cd ) contamination has posed a serious problem for safe food production and become a potential agricultural and environmental hazard worldwide .', 'Soil contamination with toxic heavy metals [ such as cadmium ( Cd ) ] is becoming a serious global problem due to rapid development of social economy .', "Ubiquity of Cd makes it a serious environmental health problem that needs to be thoroughly assessed because it already affects or will affect large proportions of the world 's population .", 'Soil cadmium ( Cd ) contamination has become a serious problem in China .', 'Soil contamination with Cd from P fertilizer and other anthropogenic and geogenic sources is a serious problem .', "Cadmium poisoning poses a serious health concern due to cadmium 's increasing industrial use , yet there is currently no recommended treatment .", 'The pollution of agricultural soils with cadmium ( Cd ) has become a serious problem worldwide .', "Cadmium ( Cd ) exposure poses a serious environmental problem due to the metal 's bioaccumulation and difficult to eliminate from body .", 'Soil contamination by cadmium ( Cd ) poses a serious environmental and public health concern .', 'Cadmium (Cd)-contaminated rice is a serious health concern .', 'Cadmium ( Cd ) contamination poses a serious problem in paddy soils .', 'Cadmium ( Cd ) stress is a serious concern in agricultural soils worldwide , and increasing accumulation and subsequent transfer to humans via the food chain can have potentially harmful effects .']


Cluster  140
['We hypothesised that oxygenation and ventilation in obese patients under deep sedation during colonoscopy using CPAP via a new nasal mask (SuperNO2VA) would be better than routine care with oxygen supplementation via a nasal cannula.', "This randomized controlled trial does not support the routine use of peppermint oil capsules prior to colonoscopy as a tool for procedure optimization, and patients' and endoscopist's satisfaction.", 'The study revealed only moderate positive effects for use of CO2 during colonoscopy.', 'The Air and CO2 Groups were similar in respect to bowel preparation evaluated using the Boston scale, age, gender, previous surgery, maneuvers necessary for the advancement of the device, and presence of polyps, tumors or signs of diverticulitis.', 'The water exchange (WE) method can decrease the discomfort of the patients undergoing colonoscopy.', 'A total of 80 patients undergoing elective colonoscopy were recruited and randomized in a double blinded fashion to receive either placebo or peppermint oil capsules administered 4\u202fh prior to the procedure.', 'bowel preparation for colonoscopy induces a semi-fasting state, with a potential negative impact on fragile patients.', 'This study examined the use of carbon dioxide (CO2) insufflation and its safety during esophageal endoscopic submucosal dissection (ESD) while under conscious sedation.']


Cluster  1742
['Ischemia-reperfusion ( IR ) injury of the small intestine is a serious problem in abdominal aortic aneurysm surgery or small intestine transplantation .', 'Intestinal ischemia , however , caused , is still a serious and growing clinical problem with an unacceptable mortality rate of over 60 % .', 'Ischemia is a troublesome problem that can cause intestinal emergencies and complicate the treatment .', 'Intestinal ischemia-reperfusion ( I/R ) injury is a life-threatening vascular emergency and has long been a disturbing problem for surgeons .', 'Intestinal ischemia-reperfusion injury is a serious and widespread clinical problem .', 'Intestinal ischaemia with ensuing gangrene has been a serious clinical problem .', 'Intestinal ischemia-reperfusion ( I/R ) is a serious clinical dilemma with high morbidity and mortality .', 'Intestinal ischaemia-reperfusion ( II/R ) injury is a serious clinical problem .']


Cluster  2141
['Our results confirm that wear rates over the first 3 years following surgery were lower in HXLPE/VitE cups than in UHMWPE cups.', 'Nevertheless , the wear of UHMWPE remains a serious clinical problem .', 'Despite the recent advancements in prosthesis design , the wear of UHMWPE remains a serious clinical problem ; the release of wear debris may induce osteolysis and implant loosening .']


Cluster  850
['The spread of multidrug-resistant bacteria is a worrisome problem worldwide .', 'Microbial drug resistance has become a serious problem of global concern , and the evolution and regulatory mechanisms of microbial drug resistance has become a hotspot of research in recent years .', 'The increasing number of infections caused by multidrug-resistant and pandrug-resistant bacteria represents a serious worlwide problem .', 'A serious , emerging problem is the arisen of extensive drug resistance afflicting most countries worldwide .', 'The increasing number of multidrug resistant bacteria raises a serious public-health concern , which is exacerbated by the lack of new antibiotics .', 'The multiple drug resistance ( MDR ) is a serious health problem and major challenge to the global drug discovery programmes .', 'The increase of the infections caused by multi-drug-resistant bacteria is a serious problem worldwide .', 'Infections due to multidrug resistant organisms have become a serious health concern worldwide .', 'Chronic infections , caused by multidrug-resistant ( MDR ) bacteria , constitute a serious problem yet often underappreciated in clinical practice .', 'The multidrug-resistant bacteria have become a serious problem to public health .', 'Therefore , due to the emergence of multi-drug resistance , the bacterial infections have become a serious global problem .', 'The emergence of bacterial resistance to multiple drugs poses a serious and growing health concern .', 'Due to excessive use of antibiotics , multidrug-resistant bacteria have become a serious threat and a major global healthcare problem of the 21st century .', 'The continuing emergence of infections due to multidrug resistant bacteria is a serious public health problem .', 'The emergence of multi drug resistant strains has become a threatening public health problem and targeting unique effectors of this pathogen can be considered as a powerful strategy for drug design .', 'Multidrug-resistant ( MDR ) bacterial strain is a serious medical problem .', 'The evolution of multidrug resistant bacteria to the most diverse antimicrobials known so far pose a serious problem to global public health .', 'The rise of multiple-drug resistance in bacterial pathogens imposes a serious public health concern and has led to increased interest in studying various pathways as well as enzymes .', 'Infections caused by multidrug-resistant bacteria are increasingly common and represent a serious problem for public health .', 'The multidrug resistance of pathogenic bacteria has become a serious problem to public health .', 'Drug resistance is a serious public health problem that threatens to thwart our ability to treat many infectious diseases .', 'Multidrug-resistant bacterial infections of the gastrointestinal tract pose a serious public health concern .', 'Multidrug-resistant Gram-negative bacterial infection is a serious global concern and especially in low and middle-income countries ( LMIC ) such as India .', 'Multi-drug resistance ( MDR ) of bacteria is a serious problem in China , including MDR of MRSA , PRSP , and enterobacteriaceae ; and the resistant rate of enterobacterinceae is the highest up-to-date .', 'Despite the availability of newer classes of antibiotics , infection with multi-drug-resistant bacteria is a serious problem .', 'Multi-drug resistance in microorganisms is a serious problem at national as well as at a global level .', 'The growing number of multidrug resistant strains in Tunisia has become a serious health concern contributing to high rate of mortality and morbidity .', 'The emergence of multi-drug resistance in pathogenic bacteria in clinical settings as well as food-borne infections has become a serious health concern .', 'Multidrug resistance has become a serious concern in the treatment of bacterial infections .']


Cluster  2174
['For macromolecules where the absorption can be described by first-order rate processes, an assumption of an inverse relationship in species size may predict the time course after subcutaneous administration and may support optimal study design for a first-in-human investigation.', 'Predicting absorption of macromolecules in humans following subcutaneous administration is complicated by interspecies differences in skin anatomy.', 'Most topical medications need a long time to penetrate into the skin owing to the stratum corneum (SC) barrier.']


Cluster  1812
['Resuscitative efforts were considered futile in 11% of cases and resuscitation was discontinued due to evidence of futility in additional 24% cases based on additional information.', 'The clinging patient . A serious management problem .', 'The purpose of this article is to define autoerotic asphyxia and present the enigma as a preventable problem .', 'This would raise a serious ethical problem of whether or not they should be intubated and kept ventilator-dependent at the time of respiratory failure , which often occurs .', 'Our case raises awareness of PAID , a life-threatening condition which can mimic many others and poses significant challenges in the acute management and rehabilitation of patients .', "A serious clinical problem arose when physicians realized that a patient 's condition was hopeless but life support perpetuated body function .", 'Twenty patients (14\xa0conscious and 6\xa0unconscious) participated in this study.', 'This is a serious habilitation problem in these patients .', 'Ten children underwent attempted occlusion using the MVP.', 'A total of 291 brain-dead patients were studied.']


Cluster  613
['LUSS8 vs LUSS12 predicted mortality in 93.', 'Plasma NGAL discriminated 28-day survivors from non-survivors on day 2 and 7 and was a relatively robust predictor of 28-day mortality prediction.', 'Overall survival (OS) in this study was 93.', 'Average survival time (13.', 'Upon Kaplan-Meier analysis, freedom from MACEs was 92.', 'Overall assessment of the preventability of death is unique to VASM.', 'The survival rate was 94.']


Cluster  265
['We conducted a randomized controlled trial with two groups: control group (n = 18) and experimental group (n = 11) in two assessments (1 and 6 months after loss); both included a semi-structured interview (Socio-Demographic Questionnaire, Beck Depression Inventory and the Impact of Events Scale-Revised-IES-R).', 'We adapted an existing form of CBTp, coping strategy enhancement (CSE), to focus specifically on distressing voices in a brief format.', 'The current study evaluates a brief evidence-informed psychological intervention developed by the World Health Organization for adults impacted by adversity (Problem Management Plus; PM+).', 'In this uncontrolled study, the intervention period was associated with reduced distress, increased confidence and ability to regulate emotion.', 'The results confirmed a responsiveness effect associated with the motive-oriented therapeutic relationship and showed a significant decrease in frequency of behavioral forms of coping, F(1, 54) = 3.', 'We found that the outside perspective of the regulator helped reducing distress more effectively than intrapersonal emotion regulation.', 'At group level, emotion processing improved following therapy (p = .', 'Compared to the neutral control, expressive writing exerted 3-month improvements in depressive symptoms (d = 0.', 'Student teams in the improvisation intervention group had increased measures of empathetic communication (p\xa0=\xa00.', 'Participants in the experimental and control groups have lower levels of depression and traumatic stress 6 months after a loss.', 'Acceptability and feasibility of the intervention were high, outcomes were relevant, and the intervention showed positive and significant results supporting the hypothesis that the intervention may help families cope with a stressful situation.', 'As there are known risks of retraumatization through bereavement crisis interventions, we tailored a new intervention lowering the degree of direct emotional activation.', 'A brief narrative-based cost-effective intervention has a positive effect on depression, controlling the traumatic stress and time after a loss.']


Cluster  89
['This prospective, observational study was conducted in 150 TOF patients, undergoing elective intracardiac repair.', 'Between January to May 2014, patients undergoing cardiac surgery were randomly assigned to control or TLV group immediately after cardiac surgery.', 'Lower postoperative blood pressure is associated with an increased incidence of postoperative cardiac hsTnT elevation, irrespective of pre- and intraoperative variables.', 'This study is performed in the cardiac operating room and Intensive Care Unit (ICU) of Shahid Madani Hospital of Tabriz (Iran) between January 1, 2014, and September 30, 2014.', 'This study was designed to examine factors influencing development of ventricular arrhythmias in adult patients undergoing cardiovascular operations during the catheter placement.', 'Stenosis of extracardiac conduit after reconstruction of right ventricle outflow tract is a serious problem , and the purpose of this study was to identify the suitability of broadly pedicled autologous pericardial flap for the reconstruction of pulmonary artery trunk in adult dogs .', 'A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B. After patients entered the operative room, blood pressure and heart rate were measured (T1).', 'Data from this large multicenter study demonstrate that approximately one-half of the patients undergoing operation for superior cavopulmonary connection are extubated within 24\xa0h after heart operation.', 'Sixty-three adult patients scheduled for elective valve replacement undergoing cardiopulmonary bypass (CPB) were randomly assigned to control or remote ischemic preconditioning treatment.', 'Cold EMR was performed on 163 SSPs during 105 procedures in 99 patients (97% women; median age, 57 years).', 'Twenty (n=20) male patients between the ages of 40 and 60 years were equally randomised to undergo elective coronary artery bypass grafting (CABG) with either cold cardioplegic arrest with topical ice slush cooling or cold cardioplegic arrest without the use of ice slush.', 'Both valvular diseases and long placement time were significant risk factors to produce multiple ventricular arrhythmias during placement of a PAC.', 'Among those completing this study, one in three patients did not experience long-term HRQOL improvements following cardiac surgery.', 'Remote ischemic postconditioning (RIPC) is suggested to protect the myocardium against ischemia in various settings.', 'The study groups showed no significant differences in clinical status and echocardiographic parameters, with a lower comorbidity rate in the complete revascularisation group.', 'During the study period, 2,512 patients underwent cardiac sugery; 1,133 (45%) completed PHQ-9.']


Cluster  1834
['In recent years , a wide distribution of non-controlled psychotropic substances has become a serious problem in Japan .', 'In spite of strict laws prohibiting it , criminal cases involving marijuana abuse are increasing , resulting in a serious social problem in Japan .', 'Despite the implementation of a new blanket scheduling system in 2013 , new psychoactive substance ( NPS ) abuse remains a serious social concern in Japan .', 'In recent years , many analogs of narcotics have been widely distributed as easily available psychotropic substances and have become a serious problem in Japan .', 'Furthermore , over-the-counter drug abuse is still a serious problem in Japan .', 'In recent years , many analogs of narcotics have been widely distributed as easily available psychotropic substances and have become a serious problem in Japan .', 'The increasing number of law-evading drug users in Japan is becoming a serious social problem .', 'In the last 10 years , many analogs of narcotic substances have been widely distributed in Japan as easily available psychotropic substances and this has become a serious problem .']


Cluster  1063
['Of the 1.', '1.', 'The total time to complete the TT was 1.', 'The DRI scores were 1.', 'One (0.', 'The IoI was equal to 1.']


Cluster  983
['this study aimed to compare between modified and traditional method of vacuum wound closure for chronic wounds.', 'The incisional negative-pressure wound therapy has a positive effect over primary closed surgical defects by significantly reducing the amount of fluid collected by closed suction drains, allowing earlier removal of drains and enhancing the skin perfusion on the repaired skin.', 'This study was a prospective, randomized, clinical trial comparing conventional dressing against a single application of negative-pressure wound therapy for 5 days after primary closure.', 'A prospective randomized controlled study was conducted in which patients with abdominal surgery and open surgery were randomly divided into a negative-pressure wound therapy experimental group and a gauze-covering control group.', 'In conclusion, although bridge-VAC treatment seems to be an alternative method to the VAC treatment by means of Y-connector, we found no superiority of one over the other VAC application for chronic diabetic foot wounds.', 'Negative-pressure wound therapy can reduce the incidence of surgical site infection in open abdominal surgery.']


Cluster  286
['While violent crime has decreased in many cities in the USA , gang-related violence remains a serious problem in impoverished inner city neighborhoods .', 'There is growing recognition in the ranks of the South African government that violence against women is a serious problem facing us all .', 'An innovative approach in the prevention and control of a serious gang violence problem was based on key interrelated strategies of community mobilization , social intervention , suppression , opportunities provision , organizational development , and targeting .', 'These actions result from a growing recognition that violence represents a serious public health problem , is an important cause of many physical and psychological illnesses , and can cause social disruptions that impede reconstruction efforts for generations .', 'Violence is a serious problem in South Africa with many effects on health services ; it presents complex research problems and requires interdisciplinary collaboration .', 'These increasing rates of violence need attention as they are a serious public health concern .', 'Violent death is a serious problem in the United States .', 'Gangs are a serious , growing , and costly problem across the nation .', 'In parts of Latin America , violence has become a serious public health and security problem .']


Cluster  1081
['Prolonged operative time ( ORT ) is a drawback of laparoscopic bariatric surgery due to concerns for increased morbidity .', 'Bariatric surgery is safe and feasible in patients over 50 years old.', 'Obesity is a serious health problem in the United States today , and surgical treatment is recognized as long-term effective therapy .', 'Bariatric surgery candidates were recruited from a single center.', 'University hospital expert in bariatric surgery METHODS: This was an observational cohort study of 140 patients who underwent bariatric surgery between September 2013 and September 2014.', 'Patients who underwent bariatric surgery had a reduced risk of heart failure after surgery compared with nonsurgical obese patients.', 'This is a qualitative exploratory study of 11 blogs of patients, who underwent bariatric surgery, that were available on the Internet between October 2013 and May 2017.', 'The Internet, particularly blogs have become an important tool for patients to disseminate and exchange information on a variety of health topics, including bariatric surgery.', 'A total of 153 bariatric patients meeting borderline personality disorder criteria were chosen voluntarily and consecutively to undergo an interpersonal individual treatment (n = 50), a dialectical behavioral group treatment (n = 50), or treatment as usual (n = 53) for a year after surgery.', "Lower level of education was associated with more than threefold increased risk of postoperative ED visits and readmission in our center's bariatric surgery patients.", 'We hypothesized that a validated behavioral assessment tool, the Cleveland Clinic Behavioral Rating Scale (CCBRS), would predict excess weight loss, health-related quality of life, depression, anxiety, and alcohol use after bariatric surgery.', 'The majority of bariatric surgery candidates were physically inactive presurgery, and there was no significant change in either subjectively or objectively measured PA at follow-up.', 'In a prospective observational study, 64 bariatric surgery patients at risk of developing obstructive sleep apnea were monitored in the postanesthesia care unit (PACU) with either capnography alone (31 patients) or capnography plus transcutaneous carbon dioxide monitoring (33 additional patients) every 3-5 minutes for the duration of their recovery.']


Cluster  1385
['Among 147 patients treated, 8 (5%) left the operation theater with a type Ia endoleak.', 'We evaluated 4 cases of retroperitoneal metastatic lymph nodes treated using US-guided Nd:YAG laser ablation.', 'All patients received initial orchiectomy followed by CHOP with or without rituximab.', 'When using OSNA technique to evaluate SLN, NSLN metastases can be predicted intraoperatively.', '83 patients treated; 50 with endoscopic therapy (EMR only-4, EMR then RFA-22, RFA only-24) and 38 by surgery (33 straight to surgery and 5 following EMR).', 'Combined ablation with chemoembolization is superior in the treatment of nonresectable single masses larger than 4\u2009cm.', 'A total of 177 consecutive patients, including 145 with curative resection (CR) and 32 with noncurative resection (non-CR), were examined.', "NSM via a hemi-periareolar incision is oncologically safe with a low-complication rate and high patients' satisfaction.", 'Overall, 12/13 patients showed a marked clinical responsiveness to medical treatment, enabling a macroscopically successful resection in all cases.']


Cluster  2122
['The aim of this study was to evaluate the functional and clinical results of early total hip arthroplasty performed to treat acetabulum fracture.', 'Intramedullary nailing for femoral shaft fractures was associated with low risk of reoperation and a nearly full return to baseline health-related quality of life at 1 year of follow-up.', 'Fractures of the ipsilateral femur after hip arthroplasty are a serious problem .', 'Femoral fracture after TKR is a serious and relatively common problem , but to the best of our knowledge , only one case of femoral condylar fracture after UKA has been reported thus far .', 'Fractures of the femoral bone shaft during and after hip arthroplasty are a serious clinical problem .', 'This prospective single-centre study included 48 patients suffering hip fractures requiring surgery and who presented risk factors for the development of AKI.', 'Femoral shaft fractures after total hip arthroplasty ( THA ) remain a serious problem , since there is no optimal surgical repair method .', 'Dislocation is a serious and common complication and a great concern with the use of total hip arthroplasty ( THA ) when treating displaced femoral neck fracture ( FNF ) .']


Cluster  2274
['Tick-borne illnesses pose a serious concern to human and veterinary health and their prevalence is on the rise .', 'The cattle tick Boophilus microplus is a serious concern to the Brazilian cattle industry .', 'Babesiosis, a tick-borne illness spread by Ixodes scapularis, is an emerging infectious disease in the Northeastern and upper Midwestern United States', 'Cattle tick control remains a serious problem in cattle farms worldwide , due to the limited success achieved with chemicals .', 'Tick-borne encephalitis ( TBE ) virus , which is usually divided into European , Far Eastern and Siberian subtypes , is a serious public health problem in several European and Asian countries .', 'Despite efforts to control tick infestations , these ectoparasites remain a serious problem for human and animal health(4,5 ) .', 'Ticks infesting cattle represent a serious problem for improvement of cattle productivity in   South Sudan .', 'Ticks were not directly or indirectly implicated in any of 16 mortalities that occurred among 61 radio-collared fawns monitored for approximately 6 mo post-partum , and were not considered a serious health problem for fawns on the study area .', 'Tick infestations and tick-borne diseases ( TBDs ) remain a serious and persistent problem , due to the lack of efficient control measures .', 'Ticks parasitizing on reptiles are known as vectors of tick-borne diseases , which indicate a serious epidemic problem , created by the import of exotic reptiles to the territory of Poland .']


Cluster  1557
['Patients undergoing laparoscopic cholecystectomy with restrictive fluid therapy may suffer more severe postoperative pain than those receiving liberal fluid therapy.', 'Modified auriculotherapy was better to the conventional analgesics for post-operative pain control in patients subjected to laparoscopic cholecystectomy.', 'We have randomized 76 patients undergoing laparoscopic cholecystectomy to receive either subcostal transversus abdominis plane block (n=38) or standard postoperative analgesia (n=38).', 'Reiki and Acupressure applied to the patients after Laparoscopic cholecystectomy decreased the pain and increased the comfort level.', 'To evaluate the effectiveness of modified auriculotherapy for post-operative pain control in laparoscopic cholecystectomy patients.', 'Performing warm up on a MISTELS system endotrainer before performing laparoscopic cholecystectomy reduces the operating time of surgery for all surgeons.']


Cluster  1092
['After baseline testing, 85 men and women (age range 60-90years) were randomized to either a supervised, progressive resistance training (n=43) or a home-based exercise (n=42) group for 12weeks.', 'A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures.', 'Post-intervention, the exercise group showed statistically significant improvement ( p = 0.', 'Thirty participants were randomly allocated to either group (A; n= 15), treated by kinesiotape with exercise program, or the group (B; n= 15), treated by exercise program.', 'This study was conducted at the Physical Medicine and Rehabilitation Clinic of our hospital between 2013 and 2015.', 'At 9 months after randomization, the exercise-based group presented a lower average cost for drugs (p-value 0.', 'Eleven healthy participants undertook a four week programme of exercise.', 'Participants were hospitalized, ambulant adults\u2009≥\u200965\xa0years randomized to individual physical therapy alone or combined with a high intensity exercise group and wore the PAL2 for five consecutive days.', 'The subjects were divided into an experimental group (Bodyblade, n= 15) and a control group (general physiotherapy, n= 15).', 'University students were randomly allocated into exercise (n: 28) and control (n: 25) groups.']


Cluster  1245
['The delamination of pharmaceutical glass is a serious issue , as it can cause glass particles to appear in vials , a problem that has forced a number of drug product recalls in recent years .', 'The occurrence of glass delamination is a serious concern for parenteral drug products .', 'Delamination of flakes in glass containers used for primary drug packaging has become a serious quality concern in recent years .']


Cluster  1945
['Both VSE and IE exercises resulted in significant improvement of the muscle functions and performance while there were no between-group differences at reassessment of the (a) cross-sectional area of longus colli and semispinalis capitis; (b) EMG amplitude in sternocleidomastoid and cervical erector spinae, and (c) peak torque values.', 'Both velocity-specific and isometric exercises significantly promoted cervical muscle functions and performance.', 'The purpose of the study was to investigate the effect of stabilization exercise training on pain and functional status in patients with cervical radiculopathy.', 'This study aimed to assess the physiological effects (measured through Range of Motion; ROM), of a commonly utilized cervical mobilization treatment during a neurodynamic test, with the appropriate methodology, i.e., compared against a control and sham.', 'To compare the effect on cervical mobility, of pressure maintained suboccipital inhibition manual technique versus a self-treatment using an Occipivot cushion, in asymptomatic subjects with limited mobility assessed by the flexion-rotation test.', 'In asymptomatic subjects with limited cervical mobility, pressure maintained suboccipital inhibition manual technique achieves further improvement on cervical range of motion than the technique using the Occipivot cushion.', 'The patients (n= 32) with cervical radiculopathy were randomized to two groups as follows: Stabilization exercise group (Group 1; n= 18); Home-exercise group (Group 2; n= 16).', 'This study has highlighted that, as expected, cervical mobilization has an effect at reducing upper limb neural mechanical sensitivity.']


Cluster  1456
['Cartilage defects represent a serious problem due to the poor regenerative properties of this tissue .', 'The progressive degeneration of articular cartilage or osteoarthritis of the knee is a serious clinical problem affecting patient quality of life .', 'Degeneration of articular cartilage in osteoarthritis is a serious medical problem .', 'Articular cartilage injury and degeneration causing pain and loss of quality-of-life has become a serious problem for increasingly aged populations .', 'Appearance of surface fissures in articular cartilage is a serious , still not fully clarified problem that deserves attention .', 'Chondrocyte biology is a hot topic , because osteoarthritis ( OA ) is a serious problem in an aging society , but there are no fundamental therapeutic drugs [ ... ] .', 'Articular cartilage damage is still a troublesome problem .', 'Because articular cartilage is avascular and has no intrinsic capacity to heal itself , physical damage to cartilage poses a serious clinical problem for orthopedic surgeons and rheumatologists .', 'Osteoarthritis (OA)-the progressive degeneration of synovial joints-is a\xa0worldwide problem that affects society, is associated with age and is the dominant reason for pain and immobility of the locomotor system', 'Degradation of mechanical properties of cartilage is a serious , still not fully clarified problem that deserves attention .']


Cluster  435
['Since A. donax is a high-yield biomass crop , reduction of biomass might be a serious agronomical problem in saline conditions .', 'Ratoon sugarcane plantlets in southern China have suffered a serious chlorosis problem in recent years .', 'The results of this work were compared with those of a similar work using sugar as the carbon source and indicate that molasses could prove a feasible technological solution to a serious environmental problem .', 'Alkaline glyphosate neutralization liquors containing a high salinity pose a severe environmental pollution problem by the pesticide industry .', 'The waste neutralization liquor generated during the glyphosate production using glycine-dimethylphosphit process is a severe pollution problem due to its high salinity and organic components .', 'Molasses is a wildly used feedstock for fermentation , but it also poses a severe wastewater-disposal problem worldwide .', 'Losses arising from the attack of Diatraea species have been a serious problem , which may cause loss in sugarcane production around 0.25 % in sugar , 0.20 % in alcohol and 0.77 % of body weight for every 1 % infestation and up to 21 % in corn production fields .']


Cluster  826
['Chronic ulceration as a complication of arteriosclerotic disease , venous congestion or diabetes mellitus is still a serious clinical problem , resulting in immobilization , extended hospitalization and cost-intensive treatment .', 'Thirty participants with chronic ulcers completed the study, their ages ranged from 47 to 65 years, from Benha city, divided randomly into two groups, it was carried out from December 2017 to March 2019.', 'Peptic ulcer ( PU ) perforation is a serious problem that leads to high complication and mortality rates .', 'Peptic ulcer bleeding is a serious medical problem with significant morbidity and mortality .', 'Stress induced gastric ulcer is a serious health problem in diabetic patients .', 'Sixteen elderly ulcer patients (seven with VLU, nine with AVLU) were treated as described.', 'Non-healing chronic ulcers are a serious complication of diabetes and are a major healthcare problem .', 'Chronic , nonhealing , cutaneous ulcers are a serious clinical problem .', 'In 78 % of cases the ulcerative disease in elderly age proceeds with complications and presents a serious surgical problem .', 'Peptic ulcer perforation is a serious problem that leads to high complication and mortality rates .']


Cluster  1561
['Resistance training induces the development of concentric cardiac hypertrophy and improves the aortic wall components by producing a morphological expression pattern distinct from aortic pathological adaptation.', 'This randomized controlled trial evaluated the effect of a multicomponent intervention, Heart Failure Exercise and Resistance Training (HEART) Camp, on adherence to exercise (after 6, 12, and 18 months) compared with an enhanced usual care (EUC) group.', 'We found that even moderate exercise is associated with improved cardiac characteristics.', 'Cardiac health is a determinant of athletic performance.', 'The multicomponent HEART Camp intervention showed efficacy with significant effects at 12 months and 18 months.']


Cluster  1858
['In Venezuela , Chagas disease ( ChD ) is considered a serious health problem , with about 6 million people at risk ; and acute outbreaks due to oral transmission of Chagas Disease ( OChD ) are becoming increasingly important .', 'Chagas disease is a serious health problem for Latin America .', 'Endemic in Latin America , Chagas disease is now becoming a serious global health problem , and yet has no financial viability for the pharmaceutical industry and remains incurable .', 'Chagas disease is a serious social-medical problem in Latin American countries because of its high incidence , morbidity and mortality .', 'Accidental transmission of Chagas disease to man by blood transfusion is a serious problem in Latin America .', 'Chagas disease remains a serious health problem for countries where the most common mode of transmission is infection contracted from the feces of a Triatominae insect vector .', "Chagas ' disease is a severe health problem , mainly in Latin America , causing approximately 50000 deaths a year and millions of people are infected .", 'Chagas disease represents a serious problem in public health .', 'Chagas disease remains a serious public health problem in several Latin American countries .', "Chagas ' disease is a serious public health problem in Latin America , and no treatment is available for the prevalent chronic stage .", 'Chagas disease ( CD ) is a serious public health problem in Latin America and its treatment remains neglected .', 'Chagas disease remains a serious medical and social problem in Latin America and is an emerging concern in nonendemic countries as a result of population movement , transfusion of infected blood or organs and congenital transmission .', 'Chagas disease remains a severe public health problem in Latin America , despite control over its transmission .', "Accidental transmission of Chagas ' disease to man by blood transfusion is a serious problem in Latin-America .", "Chagas ' disease is a serious public health problem in Paraguay , however , the immunoepidemiology of the disease has not been well documented .", 'Chagas disease , caused by the parasite Trypanosoma cruzi , represents a serious blood safety problem due to increasing immigration from Latin America .']


Cluster  1104
['The treatment of autoimmune diseases remains a serious problem .', 'The generation and expansion of regulatory T-cells with liver autoantigen specificity in vitro represents a potential immunotherapeutic tool for the reconstitution of immune-tolerance in AIH without the drawback of pan-immunosuppression .', 'Systemic sclerosis (SSc) is a chronic autoimmune disease with multiorgan involvement', 'Systemic Lupus Erythematosus (SLE) is an autoimmune multisystem inflammatory condition that causes microvascular inflammation with the production of various auto-antibodies that play a major role in its pathogenesis', 'Autoimmunity is a serious health problem and understanding the maintenance and loss of tolerance to self-antigens are key issues in developing new therapeutic strategies to treat these diseases .', "Primary Sjögren 's syndrome was long a vexing dilemma , as the underlying pathophysiological mechanisms remained obscure , disease activity was challenging to evaluate , and no specific treatments were known to be effective ."]


Cluster  463
['Despite constituting a serious health , social and economic problem , most patients remain undiagnosed and untreated due to limitations in current equipment .', 'ADEs create a serious public health problem , with negative effects on patients .', 'AD presents a serious global health concern with no cure to date , reflecting the complexity of its pathogenesis .', 'Consequently , it reiterates the fact that AH is a life-threatening disease and suggests that AH is an increasing public health concern .', 'VL represents a serious public health problem that affects many countries .', 'Participants felt RTCs are a serious problem in India and a leading cause of neurotrauma .', 'Despite improved understanding of the pathophysiology and significant advances in technology , it remains a serious problem associated with high morbidity and mortality .', 'With 35.6 million cases worldwide documented in 2011 , AD constitutes a devastating health , political , economic , and social problem for all nations .', 'T2DM has become a serious public health problem in China and even in the world .', 'In the United States ( U.S. ) , the high morbidity and mortality rates make VTE a serious health concern ( 1 - 2 ) .', "It is concluded that H is a serious problem of public health because of it 's high prevalence and lack of control , and it is necessary to implement educational and medical programs for the detection and control of this disease .", 'RTD continues to be a serious health problem over time in terms of morbidity and mortality .', 'The rapid increase in the incidence of DM is a serious public health concern worldwide .', 'Type 2 DM is rapidly rising as a global health care problem that threatens to reach pandemic levels by 2030.', 'Interest in this subject results from the continuous increase in the incidence of both diseases and complications thereof , which constitute a serious social and economic problem .', 'This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy .', 'Chronic diseases , together with injuries and poisoning , remain a serious public health problem in Estonia .', 'These data reveal that DVT is a serious health problem in Spain , with high morbidity and mortality .', 'New lifestyles driven by information technology and the rapid ageing process have brought DED a severe public health concern .']


Cluster  727
['Of patients diagnosed with biliary pathology, none had isolated CBD dilatation.', 'In this study population with a low BRD prevalence, we were not able to detect any benefit of tildipirosin as a metaphylactic treatment of BRD at day 12 after arrival based on BRD treatments, TUS, and ADG.', 'The use of a metaphylactic treatment of tildipirosin 12\xa0days after arrival of the veal calves was not associated with the number of BRD treatments performed by the producer, ultrasonographic lung consolidation or weight gain (P\xa0<\xa00,05).', 'During this follow-up, CBD was well-tolerated, and there were no severe adverse effects.']


Cluster  718
['Phytotoxicity of aluminum ion ( Al3 + ) is a serious problem limiting crop production on acid soils .', 'Acid soils constitute a severe problem for leguminous crops mainly through a disturbance in rhizobium-legume interactions .', 'Lead-polluted agricultural soils are a serious problem for food safety , with organic amendment being a promising mitigation method from the environmental perspective .', 'Soil degradation is a serious global problem , but little is known about how soil microbial communities respond to soil degradation as well as their feedback to ecosystem functioning .', 'Coastal acid sulfate soils ( CASS ) constitute a serious and global environmental problem .', 'Phosphorous ( P ) fixation in alkaline calcareous soils is a serious concern worldwide and acidified-biochar application has been proposed to improve the agronomic benefits of applied P. The present study aims to improve understanding of P transformation process in an alkaline soil following different biochar amendments ( rice-husk biochar ( RHB ) , sugarcane-bagasse biochar ( SWB ) and wheat-straw biochar ( WSB ) ) , chemically engineered ( acidification with 1 \xa0 N HCl or washing with distilled water ( pristine biochar ) ) along with or without P at 60 \xa0 mg \xa0 kg', 'Phytoremediation has emerged as an attractive methodology to deal with environmental pollution , which is a serious worldwide problem .', 'Polluted agricultural soils are a serious problem for food safety , with phytoremediation being the most favorable alternative from the environmental perspective .', 'Toxicity of aluminum ( Al ) is a serious problem for agricultural plants , especially due to excessive soil acidification caused by continuous intensive agriculture and modified environmental conditions related with global climate change .']


Cluster  70
['Fetal alcohol syndrome ( FAS ) is a serious global health problem and is observed at high frequencies in certain South African communities .', 'Heroin abuse during pregnancy is a serious problem worldwide .', 'Fetal exposure to alcohol is a serious public health problem and is associated with anomalies of the eye ground , as well as neurodevelopmental delay , growth delay , and characteristic facial features .', 'Maternal substance abuse is a serious problem with significant adverse effects to mothers , fetuses , and children .', 'Drug abuse by pregnant women is considered a serious public health problem worldwide .', 'Illicit drug use during pregnancy is a serious social and public health problem inflicting an array of deleterious effects on both mother and offspring .', 'Drinking alcohol in pregnancy is a serious public health concern worldwide .', 'Cocaine addiction is a serious health problem for pregnant women and their babies .', 'Fetal drug addiction is a serious public health problem .', 'Substance abuse during pregnancy continues to be a serious health problem in the United States .', 'Drug of abuse consumption throughout pregnancy is a serious public health problem and an important economic cost to the health system .', 'A variety of public education programs developed over the last 20 years have promoted alcohol abstention during pregnancy , yet FASD remains a serious public health concern .']


Cluster  1447
['Secondary hyperparathyroidism ( SHPT ) is a serious and common problem in patients undergoing maintenance hemodialysis .', 'However , in conjunction with disturbances in serum phosphate , Ca , and CaxP product , hyperparathyroidism has become a serious problem in the cardiovascular diseases of patients with end-stage renal disease-even patients undergoing CAPD .', 'Control of serum phosphorus remains a vexing problem in chronic kidney disease .', 'A serious problem was that 14 patients had previous experience in discarding hyperphosphatemia drugs .', 'As hypophosphatemia can be induced by various factors in advanced cancer patients, the serum phosphorus level of cancer patients at risk should be cautiously examined.', 'Secondary hyperparathyroidism remains a serious problem in hemodialysis patients .', 'In our study , we identified that hyperphosphatemia is a serious problem as hypophosphatemia for patients who admitted to the PICU .', 'Surgical treatment of a severe fixed hyperkyphosis due to ankylosing spondylitis is technically demanding but can be successfully achieved if all surgical challenges and comorbidities are adequately addressed including intraoperative surprising findings like osteopetrotic bone in a patient with hereditary hypophosphatemia as in our case .']


Cluster  909
['Individual CBT was an effective addition to TAU and showed significant improvements in symptom severity post-treatment and at 18-month follow-up.', 'Effects of CCT were assessed using a double-blind randomized controlled design.', 'Compared to an active control condition, CCT demonstrated beneficial effects on a cognitive transfer task, brooding, depressive symptomatology, residual complaints, self-reported use of general maladaptive emotion regulation strategies, and resilience after controlling for intention to treat.', 'To explore SU preferences and outcomes of different methods of delivering CBT for psychosis.', 'Semi-structured interviews were held with participants from the CoBalT trial who had received CBT, approximately 4 years earlier.', 'The 6-week transdiagnostic CBGT is feasible for a wide range of mood and anxiety disorders.', 'Patients completed questionnaires at their initial assessment (baseline), immediately before beginning CBT (pre-treatment), and after their last session of CBT (end of treatment).', 'Patients benefited from attending both modes of CR showing improved psychosocial health outcomes with 3-76% change from baseline.', 'CRT contributes to the recovery of cognitive impairment, and decreases anxiety and depression in poststroke patients.', 'This study shows that cET was successfully replicated in a new patient sample treated by different therapists than the original study.']


Cluster  199
['To date, no studies compared curative effects of thermal lesions in deep and superficial dermal layers in the same patient (face-split study).', 'Thermography is a safe, painless, and efficient method for checking the temperature of the skin.', 'Combined use of polyethylene body wrap and polyethylene cap was associated with a significantly higher mean post-stabilization temperature compared with polyethylene body wrap and cotton cap.', 'The temperature profile at the surgical wound using a microincisional sleeveless phacoemulsification technique is comparable with that of the conventional coaxial mini-incision method.', 'This study provides evidence of the positive effects of MF radio waves diathermy in the treatment of CLBP.', 'Extreme temperatures are associated with an increased risk of OHCA.', 'In the bench-top study, the mean (95% CI) pad temperature was 21.', 'To explore the effects of a deep heating therapy (DHT) produced by a MF diathermy for the treatment of CLBP compared with a superficial heating therapy (SHT).', 'Our results, showing no difference between TTM at 34°C and TTM at 36°C as to mortality or neurological outcome after OHCA, are in line with the previous TTM-trial results, supporting the use of either target temperature in our institution.']


Cluster  630
['Although the incidence of meningococcal disease is low in the United States , outbreaks remain a serious public health concern .', 'Neisseria meningitidis group C is an encapsulated bacterium that causes several diseases and is associated with high mortality rates , thereby constituting a serious public health problem .', 'Acute respiratory infections are a serious public health concern across the globe , they are , however , prominently present in Sub-Saharan Africa .', 'Invasive meningococcal disease ( IMD ) remains a serious public health problem .', 'The threat from invasive meningococcal disease ( IMD ) remains a serious source of concern despite the licensure and availability of vaccines .', 'In addition to frequent epidemics of group A meningococcal disease , endemic bacterial meningitis due mostly to Neisseria meningitidis , pneumococcus , and Haemophilus influenzae type b is a serious problem in sub-Saharan Africa .', 'Invasive infections caused by Neisseria meningitidis are a serious public health problem worldwide and have a heavy economic impact .', 'Meningococcal disease ( MD ) is a medical emergency and a serious public health problem .', 'Meningococcal disease is a serious public health problem with a case fatality of about 10 % .', 'Meningococcal disease is still a serious public health problem in many countries .']


Cluster  1333
['The production of factor VIII ( FVIII ) inhibitors is a serious problem of replacement therapy with FVIII concentrates in hemophiliacs .', 'Development of inhibitors is a severe complication of haemophilia posing many management challenges .', 'Since development of inhibitory antibodies to FVIII is a serious problem in treatment of hemophilia A patients , we investigated the potential of this approach for inducing tolerance to FVIII in a hemophilia mouse model .', 'The development of an inhibitor in a hemophiliac is a serious clinical problem .', 'The development of an inhibitor to transfused factor VIII ( FVIII ) is a serious treatment-related problem in haemophiliac children .', 'In approximately 10 to 15 percent of congenital hemophilia A patients circulating antibodies to factor VIII appear in the blood that poses a serious problem in their treatment .', 'Although the antibodies cause a serious problem for affected individuals , they have been very useful in characterizing normal factor VIII and nonfunctional factor VIII-like protein that is found in the plasmas of 10 per cent of patients with mild hemophilia .', 'The production of factor VIII ( FVIII ) inhibitory antibodies is a serious problem in patients with hemophilia A. Immune tolerance induction ( ITI ) is the only strategy proven to eradicate persistent inhibitors and has been shown to be successful in 70 % of patients with hemophilia A. However , a minority of hemophilia patients present life-long inhibitors .', 'Factor VIII (FVIII)-neutralizing antibodies ( " inhibitors " ) are a serious problem in hemophilia A ( HA ) .']


Cluster  1548
['We observed 32 subjects with AIS from our Rehabilitation outpatient clinic and divided them into the brace treatment (BG-16 subjects) and the non-brace treatment (CG-16 subjects).', 'A total of 105 patients with AIS with major thoracic curves treated with posterior instrumentation and fusion were randomized into 2 groups.', "iArmS has 3 states-free, hold, and wait-which can be carefully chosen automatically as follows: In free state, the armholder follows the surgeon's arm.", 'iArmS decreased fatigue and reduced hand trembles experienced by surgeons.', 'To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological, and cosmetic issues.']


Cluster  63
['The increasing heavy metal contamination in agricultural soils has become a serious concern across the globe .', 'Soil contaminated with heavy metals ( HMs ) is a serious problem throughout the world that threatens all living organisms in the soil .', 'Heavy metal ( HM ) pollution of farmland is a serious problem worldwide and consumption of HM-contaminated food products poses significant public health risks .', 'Soil contamination by heavy metals is a serious concern due to their toxicity and ability to accumulate in the environment .', 'Heavy metal contamination in agricultural soils has become a serious environmental concern due to their generally high mobility and toxic effects on plants and food security .', 'Soil contamination by heavy metals has become a serious problem mainly because , above certain concentrations , all metals have adverse effects on human health .', 'The accumulation of heavy metals in agricultural soils is a serious environmental problem .', 'Copper ( Cu ) induced phytotoxicity has become a serious environmental problem as a consequence of significant metal release through anthropogenic activity .', "Heavy metal polluted soils have been a serious problem for the global ecological balance and people 's health .", 'Contamination of soils with copper ( Cu ) has become a serious problem in the environment .', 'Heavy metal pollution is a serious environmental problem in agricultural soils since the uptake of heavy metals by plants represents an entry point into the food chain and is influenced by the form and amount of nitrogen ( N ) fertilization .', 'Soil contamination by heavy metals is becoming a serious environmental problem especially in saline and sodic soils and information on different fractions of metals is useful to predict their mobility and availability in soil .', 'The contamination of soil by copper ( Cu ) and lead ( Pb ) is a serious concern because of its high health risk via the food chain .', 'Contamination of arid and semi-arid ecosystems by toxic heavy metals is a serious concern due to its impact on growth and productivity of crop and health risk through food chain .', 'Soil heavy metal contamination is a serious environmental problem needed to be addressed due to the toxicities of metals to both humans and living organisms .', 'The accumulation of heavy metals in soil and water is a serious concern due to their persistence and toxicity .', 'Heavy metal contamination in croplands has been a serious concern because of its high health risk through soil-food chain transfer .', 'Heavy metal contamination of agricultural soil has become a serious global problem .', 'Soil contamination by heavy metals and metalloids is a serious problem which needs to be addressed .', 'For this reason , soil metal pollution has become a severe problem in many parts of the world .', 'The accumulation of heavy metal in the soil is a serious concern for sustainable food production due to their toxic effects on plants and other living things .', 'In recent years , toxic pollution from heavy metal(loid)s in soil has become a severe environmental problem worldwide .', 'Metal pollution in soil is a serious problem among waste landfill sites and associated environment all over the globe .']


Cluster  600
['Managing anti-epileptic drug treatment in adult patients with intellectual disability : a serious conundrum .', 'While status epilepticus (SE) persisting after two antiseizure agents is called refractory (RSE), super-refractory status epilepticus (SRSE) defines SE continuing after general anaesthesia.', 'A problem with the inspection of IEDs from the scalp electroencephalogram ( sEEG ) is that for a subset of epileptic patients , there are no visually discernible IEDs on the scalp , rendering the above procedures ineffective , both for detection purposes and algorithm evaluation .', 'Epilepsy was referred to as a serious medical problem with poor outcome by the Byzantine physicians .', 'In summary, imepitoin was well tolerated in healthy and epileptic cats and showed in a pilot trial indication for efficacy in treating feline epilepsy.', 'In AD patients, the prevalence of epilepsy of unknown origin, with onset in the adulthood before cognitive decline is 17.', 'Accurate and consistent classification of cause of death among individuals with epilepsy remains a dire public health concern .', 'The selection of optimal target areas in the surgical treatment of epilepsy is always a difficult problem in medicine', 'Super-refractory status epilepticus appears clearly less prevalent in this cohort than previously reported, probably as it is not restricted to intensive care unit.', 'Purpose . Psychiatric disorders emerging after temporal lobe resections are a serious problem threatening the surgical success of patients with epilepsy .', 'Epilepsy in the cat is a serious medical condition.', 'Intractable epilepsy is a serious neurologic problem with different etiologies .', 'Generalized convulsions in the afebrile infant represent a serious and etiopathogenically very heterogeneous problem .', 'The incidence of seizures in the Control group was 28.', 'Cyclic natural progesterone is not superior to placebo in reducing seizure frequency in women with intractable partial epilepsy.', 'Epileptic seizure is a serious health problem in the world and there is a huge population suffering from it every year .', 'Injuries from seizures are a serious , persistent problem in childhood onset epilepsy : a population-based study .', 'Epilepsy is a neurological disorder characterized by an enduring predisposition to generate and aggravate epileptic seizures affecting around 1 % of global population making it a serious health concern .', 'Sudden unexpected death in epilepsy ( SUDEP ) is a serious concern for epilepsy patients .', 'Although most FS may not represent a serious health problem , those that are more prolonged and recurrent may cause hippocampal damage which is the most important pathological basis of temporal lobe epilepsy .', 'This single-center, retrospective observational study included consecutive adult patients who presented with convulsive seizure and were referred to an urban tertiary care emergency department between August 2010 and April 2016.', 'Dissociative seizures ( DSs ) , also called psychogenic non-epileptic seizures , are a distressing and disabling problem for many patients in neurological settings with high and often unnecessary economic costs .', 'Depression in patients with epilepsy is a serious medical and social problem since it afflicts almost one half of all patients treated in epilepsy referral centers .', 'Uncontrolled seizures are a serious problem and a source of much anxiety to physicians , parents and others concerned with the care of children with epilepsy .', 'With the ever-increasing popularity of computers , electronic screen game-induced seizure ( ESGS ) is beginning to pose a serious social problem .', 'Conditions , in which neurodevelopmental disorders are associated with the marked epileptiform EEG activity , while clinical epileptic seizures are absent , represent a serious problem .', 'According to the results of this study, intravenous immunoglobulin may be an effective therapy for reducing the frequency and duration of seizures in paediatric patients with drug-resistant epilepsy.', 'Neurodegenerative processes of dementia could play a key role in the pathogenesis of epilepsy in a subgroup of individuals intended to develop cognitive decline.', 'Once the diagnosis has been established , severe convulsions , often unpredictable and long-lasting , are still a major worry , but developmental and behavioural problems also rapidly become a serious concern .', 'Medically intractable temporal lobe epilepsy ( TLE ) remains a serious health problem .', 'The Byzantine physicians considered epilepsy to be a serious medical problem and followed the Hippocratic tradition as far as the etiology of this disease is concerned .']


Cluster  1241
['These results suggest an awareness of the symptoms , but not necessarily a serious health problem .', 'They could be a serious diagnostic problem in the absence of corresponding epidemiological data and typical symptoms and signs of the disease .', 'Anecdotal reports imply that chronic medical problems may be a serious concern for mediums .', 'The main problem with these tumours is that they induce vague , non-specific symptoms , causing a delay in diagnosis , which is often reached in cases of acute complications such as intestinal obstruction .', 'The case presents a serious diagnostic and management problem .', 'These pathologies represent a serious problem , not only concerning the quality of life of the patient , but in addition , the enormous economic efforts that society has to do for their treatment .', 'Treatment procedure complications and coexisting diseases constitute a serious diagnostic and therapeutic problem .', 'This article outlines an aggressive and comprehensive diagnostic approach in order to prevent overlooking a serious problem .', 'This could be a serious diagnostic problem in the absence of corresponding epidemiological data and typical symptoms and signs of the disease .', 'They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature .', 'The poor prognosis in some cases , the increasing incidence in western populations and the lack of therapeutic options renders NASH to a serious problem .', "They include ' locking ' and disregard of further data pointing to possible diagnostic error ; pursuing a diagnosis when further information has little practical significance ; a severe impact of the news on the patient ; a ' stigma ' effect ; loss of the patient 's individual narrative ; stopping the diagnosis short of the full pathogenesis or of its finer characterization ; disregarding additional medical issues ; losing interest in the patients once the diagnostic problem is solved ; and assuming full control of future decisions at the expense of the patient 's autonomy .", 'They are a serious health problem because in 90 % of the cases , the causes are not determined and in a similar percentage , the results of treatment are not satisfactory either to the patient or the consulting physician .', 'The biggest problem that we are currently facing with this type of malignancy is that patients are usually diagnosed in late stages with few alternatives regarding therapy .', 'Therefore , delay in diagnosis is a serious problem that needs to be addressed .', 'As a result , diagnosis of the various disorders presents a serious problem .', 'These findings have significant clinical implications.', 'A minority of cases , however , pose a vexing diagnostic dilemma .', 'MD may remain clinically silent for lifetime, or it may have life-threatening complications.', 'Diagnostic difficulty makes detection complicated and this , in conjunction with the low survival rate , renders the disease a serious health problem .']


Cluster  382
['Multiple sclerosis is considered a complex and heterogeneous disease.', 'Describe patient-reported clinical and treatment experience in NMOSD and compare disease characteristics of NMOSD with those of multiple sclerosis (MS).', 'Multiple sclerosis is a central nervous system demyelinating disease with unknown etiology', 'The results showed that klotho gene expression in the PBMCs of patients with RRMS is nearly 2.', 'We discovered a significantly increased frequency of MS among patients with BP.', 'This is the first study demonstrating a possible role of Klotho in the PBMCs of MS patients.', 'JCVAb seropositivity was comparatively high in Japanese MS patients.', 'The interaction between lactate and UA is associated with a higher prevalence of MS in the Chinese population.', 'JCVAb indexes were measured in 149 serum samples from 105 patients with MS.', 'Our systematic review suggested a high prevalence of MS among subjects in Mainland China , indicating that MS is a serious public health problem .', 'The results suggest that the morbidities that compose MS are a serious publichealth problem in that population .', "Multiple sclerosis (MS) is one of the world's most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility"]


Cluster  16
['Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice .', 'A greater percentage would terminate a pregnancy for a serious medical problem .', "The overarching theme to emerge was that women 'felt trapped between a rock and a hard place', in not wanting to feel the way they did, but also not knowing what else to do, as conventional treatments had been inadequate or unsatisfactory, or were now unacceptable during pregnancy.", 'PND was a serious health problem with 50.3 % of the mothers who suffered from PND .', 'This lack of basic information by those who advise pregnant women points to a serious public health problem .', 'Overall , 34 % of women and 31 % of men felt that prematurity is a common problem in the United States , and 38 % of women and 25 % of men believed prematurity to be a serious problem in the United States .', 'Dystocia is a serious problem for pregnant women , and it increases the cesarean section rate .', 'Hyperemesis gravidarum is a serious health problem for the fetus and the mother .', 'The death of women during pregnancy , childbirth or puerperium , remains a serious public health problem worldwide .', 'Technological advances have increased our ability to detect a life-threatening , life-limiting or lethal problem early in pregnancy , leaving parents months to anticipate a death or a prematurely born infant .', 'The study participants considered premature birth to be a serious health problem , and over-estimated the premature birth rate .', 'Prenatal dietary advice was perceived as somewhat restrictive , and for approximately a third of the subjects , compliance with dietary advice was a serious concern .', 'Lack of local data on pregnancy intendedness poses a serious problem for those responsible for regional program development and evaluation .', 'Notably , all participant mothers ( 100 % ) did not understand that NTDs are a serious health problem associated with inadequate intake of FA and none of them used FA prior to conception .', 'Fear of childbirth is a serious problem that can have negative effects on both women and babies and to date treatment options are limited .', 'Birth beliefs are pivotal in the decision-making process regarding preferred and actual birth options.', 'Stronger beliefs about birth being natural were related to preferring a more natural place and mode of birth and preferring more natural birth-related options.']


Cluster  717
['TLCB and BAL were performed under general anesthesia through the same bronchoscopic access on 103 adult patients (including immunocompromised HIV+ individuals) with clinical/radiological evidence of non-interstitial lung disease admitted to the Interventional Pulmonology Service between May 2015 and April 2016.', 'The findings of this study do not support the administration of topical nasal xylometazoline in flexible bronchoscopy.', 'To evaluate the diagnostic yield and safety of an interventional pulmonology approach that integrates TLCB and bronchoalveolar lavage (BAL) for the diagnosis of non-interstitial pulmonary disease.', 'In total, 66 patients who underwent bronchoscopy without sedation were randomly assigned to either oral or nasal insertion.', 'Forty-four patients showed fever within 24\xa0h following bronchoscopy (14%).', 'The aim of this paper was to evaluate the safety of LMA-assisted bronchoscopy compared to standard nasal bronchoscopy.', 'The aim of this study was to physiologically evaluate bronchial obstruction during interventional bronchoscopy.', 'Flexible bronchoscopy is a frequently used procedure for the diagnosis and treatment of various lung disorders.', 'This prospective, open-label, single-arm study was conducted in patients undergoing routine bronchus examination with FB.', 'We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy.', 'Strategies to improve the efficiency of bronchoalveolar lavage (BAL) are needed.', 'Forty-four participants were allocated to 3 groups based on prior bronchoscopic experience [novices (n=31) with no prior experience, intermediates (n=7) with prior experience of 5 to 10 bronchoscopies, and expert bronchoscopists (n=6) with minimum 200 prior bronchoscopies performed].']


Cluster  2215
['In this observational study, six videos of anaesthesia providers were analysed from a single centre in the United States.', 'Mean HR and several linear and non-linear HRV metrics including subjective workload ratings differed significantly between stages of anaesthesia.', 'When the patient with SSc is to be operated , the anesthetic procedure could be a serious problem .', 'Awareness during general anesthesia with subsequent explicit recall is a serious and frequently preventable problem that is gaining attention from clinicians and patients alike .', 'Observational, prospective study in a Post-Anesthesia Care Unit (PACU) in patients aged above 45 years, after elective major surgery.', 'In this exploratory study based on short ECG segment analysis, PeEn and HR seem to be promising to separate workload levels between different stages of anaesthesia.', 'We analyzed 97 discussions involving 41 different anesthesia providers.', "An anaesthesia provider's time was occupied primarily by three tasks: patient (mean: 30.", 'A total of 166,491 anesthesia records from March 2015-October 2020 were reviewed.', 'Any patient presenting for anesthesia and surgery who has a severe debilitating problem is at great risk for a prolonged recovery , renal failure , or hypotension .', 'This is an observational study using the Pediatric Regional Anesthesia Network (PRAN) database.']


Cluster  1267
['Transurethral intracorporeal lithotripsy is the modality of choice for the endoscopic disintegration of large, long-standing, radiolucent or high-density stones.', 'Bile duct stones >1 cm have a decreased incidence of successful endoscopic extraction and often require lithotripsy.', 'Endoscopic clearance was achieved in 39 (93%) of 42 patients treated with cholangioscopy-guided laser lithotripsy and 12 (67%) of 18 treated with conventional therapy only (P\xa0= .', 'ERCP with stone removal is the standard treatment for common bile duct stones (CBDSs).', 'Cholangioscopy-guided laser lithotripsy increases the incidence of endoscopic clearance of large bile duct stones and decreases the need for surgery compared with conventional therapy alone.', 'eSWL is a safe procedure and delivers high SFR even within 24 hours especially for <10 mm stones.', 'We describe a new technique - endoscopic intracorporeal lithotripsy in the gas (СО2) medium.', 'Patients with bile duct stones >1 cm in diameter were randomized in a 2:1 ratio to cholangioscopy-guided laser lithotripsy versus conventional therapy only.']


Cluster  1250
['Low QRS voltage, male gender, NEWS, and impaired mobility were independent predictors of in-hospital mortality in the study population.', 'Prospective observational study of vital signs, QRS voltage and simple tools used to assess mental, functional and nutritional status at the bedside in unselected acutely ill patients admitted to a resource-poor hospital in sub-Saharan Africa.', 'However , the main problem associated with this method is that the signals recorded from the maternal abdomen are affected by noise and interferences : the maternal electrocardiogram ( mECG ) being the dominant interference .', 'However , because of the low reliability of the wireless data transmission , sensed vital data are often lost in the wireless channel and this is a fatal drawback of the devices for continuous monitoring of patients in hospitals .', 'Smartphone pulse oximeters were unreliable compared to a hospital pulse oximeter.', 'Skin conductance variability, selected hemodynamic and respiratory parameters, bispectral index (BIS) and ambient noise level, were monitored during 4 hour routine daytime intensive care nursing and treatment in an adult Intensive Care Unit.', 'A main drawback of the proposed algorithm is however that some arrhythmia types such as left bundle branch block and right bundle branch block beats can not be detected using only the features extracted from the HRV signal .', 'While aging is a serious global concern , in-home healthcare monitoring solutions are limited to context-aware systems and wearable sensors , which may easily be forgotten or ignored for privacy and comfort reasons .', 'This is to our knowledge the first report about the potential of an affordable , contactless , and unobtrusive ambient sensor system for the detection of early signs of HF decompensation based on data with prospective data acquisition and retrospective correlation of the data with clinical events in a 91 year old senior with a serious heart problem over 1 year .']


Cluster  310
['To document the occurrence of cervical spine and middle dorsal thoracic mycetomas, as well as their severity, clinical manifestations, and secondary complications.', 'Despite recent advances in treatment medulloblastoma continues to remain a vexing problem .', 'Type II and III tumors were more common in males (unlike the overall cohort), presented more often with\xa0seizures, and were associated with less favorable postoperative outcomes.', 'Post-operative recurrence in mycetoma after adequate medical and surgical treatment is common and a serious problem .', 'Pediatric brain tumors are a vexing problem for the neurosurgeon due to the fragile patient cohort .', 'The overall incidence of symptomatic neuromas was 4.', 'Cephalhematoma is more frequently associated with hard labor of infancy, but the incidence of ossified cephalhematoma is a rare clinical entity', 'Surgical removal of intraspinal tumors provides the best hope of control , but spinal column deformity after laminectomy and irradiation is a serious long-term problem in children .', 'Unresectable meningioma is the cause of a serious clinical problem , for whom no satisfactory mode of treatment is currently available .', 'We describe three cases initially diagnosed clinically as cervical mycetomas and one in the middle dorsal thoracic region.', 'Intracranial meningiomas in young HIV-1-positive patients tend to be of high grade; therefore, conservative or noninvasive therapies should be offered with caution and only after tissue diagnosis has confirmed benign WHO grade.', 'Malignant neoplasms of the nose and paranasal sinuses occur rarely but due to late diagnosis and poor treatment effects still remain a serious problem .']


Cluster  1427
['A randomised, controlled trial was conducted at University Hospital Limerick.', 'A randomized controlled trial was conducted from May 16th, 2013 to March 25th, 2014 at the Children Hospital of Lyon.', 'We conducted a single-centre open-label parallel randomised controlled trial in Guangzhou, China.', 'We performed a 12-month cluster randomized trial, during which 8 primary care clinics received practice facilitation.', 'This prospective observational trial was conducted in an academic medical center.', 'This open-label randomized trial was done at a tertiary care center from January 2009 to October 2015.', 'This is a prospective, randomised controlled study conducted at an Australian tertiary hospital from October 2013 to February 2015.', 'A randomized controlled trial in a large tertiary referral hospital in Australia has recruited 200 patients and will follow them for 12 months.', 'A randomized, prospective, comparative, multicenter study on two parallel groups, conducted in private practice and in hospitals.', 'A randomized controlled trial with a 1-year follow-up was conducted in one hospital in Finland in 2011-2015.', 'Cluster randomised controlled trial with patients admitted to four adult internal medicine services of an urban, tertiary care hospital.', 'We performed a multicenter, crossover, prospective, randomized controlled trial in 3 hospitals in China.', 'A randomized prospective trial was conducted at a large teaching hospital over ten months.', 'We conducted a randomized, manikin trial on healthcare providers.', 'This cluster-randomized trial was conducted between December 2 and December 31, 2013, in 10 internal medicine wards and 10 surgery wards at a tertiary referral teaching hospital in Xiamen, China.']


Cluster  935
['This should , however , not pose a serious problem as in most applications of impact assessment , model results are not needed in real time but in statistical terms .', 'The problem with this indicator is that the impact factor of several journals not listed in the Science Citation Index database is largely unknown .', 'A serious drawback of the flux estimation method in current use is that it does not produce confidence limits for the estimated fluxes .', 'The problem with such correlational studies is that it is impossible to infer causality .', 'A major drawback of such approaches is that it is not possible to evaluate the health impact of each pollutant .', 'The fundamental problem with prior approaches is that no estimate of concurrent change is made .', 'However , a major drawback of these studies is that no controls have been placed on the type of Internet use investigated .', 'A problem with epidemiological studies is that the comparatively-small effect of air pollution is difficult to identify in the presence of larger and variable effects of cigarette smoking and other factors .', 'A drawback of existing indexes is that they estimate no known population parameters .', 'A limitation of the study is that observational studies cannot establish causality.']


Cluster  1373
['The infectious and parasitic diseases of childhood must remain a priority at the same time the chronic diseases among adults are emerging as a serious problem .', 'This coupled with the rather fast emergence of parasite resistance , presents a dire public health concern .', 'Parasitic infections are a serious public health problem because they cause anemia , growth retardation , aggression , weight loss , and other physical and mental health problems , especially in children .', 'Moreover , parasite resistance to existing drugs has become a serious problem .', 'Human parasitic infections are a serious problem in tropical and sub-tropical developing countries .', 'Intestinal parasitic infections are still a serious public health problem in poor and developing countries like Ethiopia .', 'Intestinal parasites are a serious problem in developing countries , but should not be underestimated in industrialised countries .', 'The rapid spreading of the parasite has become a serious problem to veterinarians and bee-keepers in many countries of the world .', 'HIV coinfected with other parasitic diseases may cause a serious problem for the patients .', 'Despite a significant civilization advancement , parasitic diseases still pose a serious diagnostic and therapeutic problem .', 'Intestinal parasite infections are a serious public health problem , mainly in underdeveloped countries , and are usually associated with ( and aggravated by ) poor sanitation and lack of information .', 'Intestinal parasites , especially protozoa , are highly prevalent , indicating that parasitic infections are still a serious public health problem .', 'Infection is detrimental to growth , making it a serious problem for both humans and animals .', 'Therefore , E. multilocularis , the causative agent of a serious parasitic zoonosis , might be of major concern for public health and a challenge to control .']


Cluster  1776
['The increase in the prevalence of drug-resistant Acinetobacter baumannii is a serious public health concern , which is closely linked to the formation of biofilm .', 'Infections caused by multidrug-resistant Acinetobacter baumannii have emerged as a serious global health problem .', 'Nosocomial infections and persistence of multidrug resistant biofilm forming Acinetobacter baumannii in hospitals has made it as a serious problem in healthcare settings worldwide .', 'Colistin resistance among extensively-resistant Acinetobacter baumannii isolates is a serious health-care problem .', 'Acinetobacter baumannii has become a serious concern in clinical practice owing to its multiple resistance to antimicrobial agents .', 'Acinetobacter baumannii-induced nosocomial pneumonia has become a serious clinical problem because of high antibiotic resistance rates .', 'The increase in the prevalence of multidrug-resistant Acinetobacter baumannii infections in hospital settings has rapidly emerged worldwide as a serious health problem .', 'Nosocomial infections caused by multidrug resistant Acinetobacter baumannii have emerged as a serious problem in healthcare settings worldwide .', 'Multiple drug resistance of clinically isolated Acinetobacter baumannii is a serious problem in Changsha .', 'Increase in multidrug-resistant Acinetobacter poses a serious problem in Korea .', 'Even though meningitis caused by Acinetobacter baumannii is relatively rare , it is associated with high mortality rates especially in neurosurgery patients and represents a serious therapeutic problem due to the limited penetration of effective antibiotics into the cerebrospinal fluid .', 'The increased incidence of multidrug-resistant ( MDR ) Acinetobacter baumannii ventilator-associated pneumonia in critically ill patients poses a severe therapeutic problem .', 'Acinetobacter baumannii is a serious concern amongst hospitalised patients worldwide and its resistance to antibiotics has emerged as a threat to public health in recent years .', 'Multidrug-resistant strains of Acinetobacter pose a serious therapeutic dilemma in hospital practice , particularly when they cause meningitis , as the few antimicrobial agents to which these isolates are susceptible have poor central nervous system ( CNS ) penetration .']


Cluster  1836
['All-inside ACLR using cortical button fixation results in increased femoral tunnel widening in comparison with ACLR with biodegradable interference screw fixation.', 'Reestablishing knee stability is the core of the treatment of ACL (Anterior Cruciate Ligament) injury.', 'This new surgical technique using eight to 10\u202fmm allograft bone cylinders for the management of excessive tunnel enlargement at single stage revision ACL reconstruction delivers excellent results after minimum one year of follow-up.', 'Concomitant soft tissue injury resulting from knee instability following cruciate rupture is a serious clinical problem .', 'No correlation was found between duration of injury and presence of viable mechanoreceptors, hence it is beneficial to preserve the native ACL stump irrespective of the time interval between injury and surgery.', 'A total of 38 injured native ACL stumps were harvested from patients undergoing ACL reconstruction and stained with neurofilament protein stain to detect functional mechanoreceptors.', 'Anterior cruciate ligament ( ACL ) injuries are a serious problem , with a high incidence and serious consequences .', 'DBPTB allografts had fewer graft failures at three years than 4SHS grafts for anterior cruciate ligament reconstruction; and there were statistically significant differences but not clinically significant differences between DBPTB and 4SHS grafts in terms of the KT1000 test, IKDC and Lysholm scores.']


Cluster  1008
['The results of this study support the integration of hybrid simulation experiences throughout the nursing curriculum, as evidenced by positive responses from students through the simulation evaluation questionnaire.', "This study sought to determine the effects of clinical simulations with simulated patients (SP) on the physiotherapy students' clinical decision-making within a role-playing (RP) scenario while caring of LBP patients.", 'Theory-based, structured prebriefing can impact nursing student competency performance, clinical judgment and perceptions of prebriefing, and may enhance meaningful simulation learning.', 'This study evaluated an innovative simulation-based teaching method for nurses.', 'Simulation is an effective teaching strategy.', 'The aim of this study is to analyze the effects of a hybrid simulation technique used with nursing students in a scenario about the emergency setting.', "In recent years, simulation educators have focused on in situ simulations wherein they bring education to providers' workplaces in efforts to reduce clinical disruptions and eliminate travel costs", 'To compare the effectiveness of two maternal newborn clinical simulation scenarios; virtual clinical simulation and face-to-face high fidelity manikin simulation.', 'This pilot study suggests that simulation-based education may be more effective for teaching the basic concepts of ACS.', 'Two interventions were incorporated into the curriculum to increase student competency: a student-designed simulation project (SDSP), and a Good Catch and Error Reporting (GCER) program.', "To measure the impact of productive failure on nursing students' declarative knowledge, explanatory knowledge, and transfer of knowledge compared to a direct instruction approach in a paediatric closed head injury simulation.", 'Hybrid simulation can be developed with mannequins of any fidelity and tabletop simulators with a standardized patient to create a complex, high-level learning activity.', 'The aim of this study was examining the effect of simulation-based learning on IV therapy administration knowledge, performance and clinical assessment skills of first-year nursing students.', 'Nearly all participants reported that the simulation improved their critical thinking, decision-making skills, and self-confidence before the clinical activity and that they felt as though they were real nurses during the activity (94.', 'This study demonstrated that a productive failure simulation that leads learners to make mistakes before receiving instruction can facilitate deeper levels of explanatory knowledge and enable the transfer of learning to new clinical situations.']


Cluster  698
['An unanticipated difficult airway during induction of anesthesia can be a vexing problem .', 'One hundred and forty patients aged 19 to 70 years (American Society of Anesthesiologists classification I or II) who required tracheal intubation for elective surgery were randomly allocated to 1 of 2 groups, at the 60° angle (n\u200a=\u200a70) or the 90° angle (n\u200a=\u200a70).', 'Post intubation long segment tracheal stenosis is a serious problem which usually requires multiple methods of treatment .', 'We investigated whether facing the bevel of the tracheal tube in the cephalad direction of the patient could help in advancing the tracheal tube through the lower pathway during nasotracheal intubation.', 'Low-dose rocuronium provided significantly worse overall intubation conditions compared to the conventional dose of rocuronium for rapid tracheal intubation.', 'Endotracheal intubation was successfully completed in all patients.', 'We compared the effectiveness and safety of endotracheal intubation using the GlideScope (GS) video laryngoscope, CTrach laryngeal mask airway (LMA), or Shikani optical stylet rigid laryngoscope (SOS) during elective cervical surgery.', 'One hundred forty adult patients ASA I and II with normal airway, scheduled to undergo elective surgery under GA requiring ET intubation were enrolled in this prospective randomized study and were randomly divided in two groups, GL and MCL.', 'Facing the bevel of the tracheal tube in the cephalad direction of the patient facilitated selection of the lower pathway and reduced the incidence of epistaxis during nasotracheal intubation in patients undergoing oromaxillary surgery.', 'Microcuff pediatric tracheal tube is associated with significantly lower incidence of stridor, tube changes, and anesthetic gas requirement.', 'When intubating the patients with the McGrath videolaryngoscope, the 60° angled stylet allowed for faster orotracheal intubation than did the 90° angled stylet.', 'Rotational and triple airway maneuver insertion techniques are acceptable alternatives.', 'In this observational study, all children with predicted criteria of potential difficult intubation and requiring general anaesthesia with tracheal intubation were prospectively enrolled over a 12-month period.', 'Eighty-four patients aged 1-10 years who underwent endotracheal intubation for elective surgery were randomly assigned to the McGrath group (n = 42) or the Macintosh group (n = 42).', 'Ultrasound and fiberscope achieved comparable time for tracheal intubation (57\xa0±\xa012 vs.', 'The nonswallow procedure of nasogastric tube intubation relieves discomfort and ensures the safety of patients.', 'Use of the videolaryngoscope McGrath Mac did not reduce the nociceptive stimulation induced during intubation as evaluated by the automatically administered remifentanil concentration.', 'Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia.', 'Insertion and adequate ventilation were achieved in 185 patients at the first attempt, and 12 patients required a second attempt.', 'In total, 60 adult patients diagnosed with cervical instability or at risk of secondary cervical injury, who were planned for awake intubation and/or self-positioning prone, were registered in this study and were randomly categorized into 2 equal groups (30 patients each), a fiberoptic group and an SOS group, followed by assessment of coughing and gagging during intubation, time to successful intubation, number of attempts for successful intubation, and hemodynamic parameters.', 'Use of video laryngoscope and endotracheal tube assistance during NG tube insertion compared with conventional technique increase the success rate and reduce the kinking in anesthetized and intubated adult patients.', 'Management of the difficult pediatric airway is a serious problem that anesthesiologists face in their practice .']


Cluster  2308
['Hepatitis B infection remains a serious public health problem in northwest China .', 'Hepatitis B virus ( HBV ) infection remains a severe clinical concern in China .', 'Taiwan is an area with a high prevalence of HBV where hepatitis B flare-up has become a serious problem of HBV carriers who must rely on chemotherapy to treat their diseases .', 'Hepatitis B is a serious public health problem in China .', 'Hepatitis B Virus ( HBV ) infection is a serious health problem among Asian Americans .', 'Chronic hepatitis B ( CHB ) is a serious health problem in Korea .', 'Vietnamese males have the highest incidence of liver cancer of any ethnic group , and HBV infection is a serious and prevalent health problem among Vietnamese immigrants .', 'Hepatitis B virus infection poses a serious health problem in Taiwan , and plays an important role in the development of chronic hepatitis , liver cirrhosis and hepatoma ; the latter two are among the 10 leading causes of death in Taiwan .']


Cluster  2012
['We genotyped 60 APS patients and 41 controls, for protein Z-79 G/A gene polymorphism using the PCR-restriction fragment length.', 'According to our results the AA allele combination can be considered as a risk factor.', 'Unfortunately , our results question some disease-related genotyping analyses , raising a worrisome concern on their validity .', '18 of them (90%) with Child-Pugh A, 11 (55%) with genotype 1a, 17 (85%) with more than 1 and 8 (40%) with more than 2 previous failed treatment; all patients had at baseline NS3 resistance-associated variants related to triple therapy failure.', 'At present , the little correlation that seems to exist between these different genotypes and the severity of the disease poses a serious dilemma for genetic counselors .', 'To investigate the prevalence and clinical significance of the protein Z-79 G/A gene polymorphism in Egyptian patients with antiphospholipid syndrome (APS).', 'Four pathogenic and six likely pathogenic sequence variants were identified in 11 patients from 10 of the 27 families (37%) included in the study.', 'In total, 135\u2009853 patient and 62\u2009080 donor samples were analysed for ABO typing discrepancies.', 'We observed a higher prevalence of the A allele in the controls when compared to the APS patients (P Value\u202f=\u202f<0.', 'The rapidly increasing number of mutations responsible for clinical and enzymological phenotypes and the very large number of statistically possible combinations among them for compound heterozygosity pose a serious pragmatic problem for classification and nomenclature of this group of rare genetic disorders .', 'Considering APOE genotyping, three patients had ε2/ε2, four had ε2/ε4, 38 had ε2/ε3, 284 had ε3/ε3, 51 had ε3/ε4 and four had ε4/ε4.']


Cluster  301
['Treatment of cancer patients remains a serious medical problem and the development of alternative treatment strategies is therefore of great importance .', 'Metastatic breast cancer is a devastating problem , clinical application of I3C as a potent chemopreventive agent may be helpful in limiting breast cancer invasion and metastasis .', 'A common drawback of many anticancer therapies is non-specificity in action of killing .', 'Tumor hypoxia is a serious and enduring problem for traditional solid tumor therapies .', 'This is a severe concern of this research , and an attempt was made to prepare a target-specific formulation that could circumvent chemotherapyrelated compilation and improvise higher cellular uptake .', 'A major drawback of the current antineoplastic treatments is their lack of specificity toward cancer cells , because they are most often cytotoxic to normal cells , thus creating related side effects .', 'Resistance to chemotherapy ( chemoresistance ) is a serious problem in malignant mesothelioma , a highly aggressive neoplasm .', 'Inactivation of antineoplastics is a serious problem in cancer therapy , and prevention of the inactivation is a surpassing strategy for enhancement of their therapeutic effects .', 'Cancer is one of the most awful lethal diseases all over the world and the success of its current chemotherapeutic treatment strategies is limited due to several associated drawbacks', 'A major drawback of hyaluronic acid (HA)-based drug conjugates or nanoparticles for cancer therapy is their preferential accumulation in the liver after systemic administration .', 'According to several authors, neutrophil extracellular traps (NETs) play an important role in the mechanisms of cancer development and metastatic processes, which allows them to be considered as a potential new target for the treatment of cancer', 'Bent metallocenes ( BM ) have anti-tumor properties but they face a serious drug efficacy problem due to poor aqueous solubility and rapid hydrolysis under physiological conditions .', 'Tumors that acquire resistance against death stimuli constitute a severe problem in the context of cancer therapy .', 'Chemoresistance of cancer cells has been a severe problem in multiple types of cancers .', 'The occurrence of chemoresistance is a serious problem in the treatment of cancer , urging the need for second and third-line treatment options that rely on different cell death pathways to overcome previously acquired resistance mechanisms .']


Cluster  757
['Diabetes is a serious and chronic problem that can be attributed to the insufficient release of the insulin or when body does not respond to the insulin which is already present .', 'Diabetes mellitus constitutes a serious public health problem .', 'The incidence of diabetes is increasing at an unprecedented pace and has become a serious health concern worldwide during the last two decades .', 'Diabetes is a serious health problem and a source of risk for numerous severe complications such as obesity and hypertension .', 'Diabetes is a serious , costly , and major health problem worldwide .', 'Diabetes is a serious health problem affecting approximately 29.1 million individuals in the United States .', 'Diabetes Mellitus ( DM ) is a serious medical problem that causes long-term systemic complications and considerable associated morbidity .', 'Diabetes mellitus is a chronic degenerative disease that causes long-term complications and represents a serious public health problem .', 'Diabetes mellitus is a serious problem that will soon reach epidemic proportions in the United States and throughout the world .', 'Diabetes mellitus is a serious and growing health problem worldwide and is associated with severe acute and chronic complications .', 'Epidemiological studies show that diabetes mellitus is a serious medical , economic and public health problem .', 'Diabetes mellitus ( DM ) is a serious global health problem currently affecting over 450 \xa0 million people worldwide .', 'Diabetes mellitus is a chronic degenerative disease that causes long-term complications and represents a serious public health problem .', 'Diabetes mellitus ( DM ) is a serious medical problem .', 'Diabetes is a serious public health problem in the United States .', 'The rise in the incidence of diabetes is a serious public health concern .', 'Global epidemic of diabetes is a serious health care concern because of its complications and consequently reduced life expectancy and increased morbidity .', 'Diabetes mellitus ( DM ) is a serious health and social problem .', 'Diabetes is a serious health concern .', 'Diabetes mellitus is a serious health and economic problem of our time .', 'Diabetes is a debilitating health care problem affecting 422 million people around the world .', 'In the United States ( US ) , diabetes mellitus is a serious and costly public health problem , affecting more than 16 million people .', 'Diabetes mellitus ( DM ) is a serious medical problem affecting millions of peoples worldwide , and has a great socio-economic impacts .', 'Diabetes mellitus is a chronic metabolic disease which is a serious global problem .', '\xa0Diabetes mellitus (DM) is considered to be a significant public health problem globally', 'Diabetes is a serious health problem .', 'In recent decades , Diabetes Mellitus has become a severe and growing global public healthcare problem due to the increase of its prevalence , morbidity and mortality .', 'Diabetes , a serious public health problem , is on the rise , claiming millions of victims .', 'Diabetes , a disease in which the body does not produce or use insulin properly , is a serious global health problem .', 'Diabetes is a serious health problem .', 'Diabetes is a devastating and growing problem in the USA and throughout the world .', 'Diabetes mellitus has become a serious and growing public health concern .', 'Prevalence of diabetes , a serious public health problem is rapidly increasing worldwide .', 'Diabetes is a serious health problem .', 'Diabetes mellitus ( DM ) due to its increasing prevalence and associated morbidity and mortality has become a serious public health problem .']


Cluster  2278
['Traffic crashes are a serious public health and socio-economic problem , and they are one of leading causes of death of males in Serbia .', 'Fatalities and injuries resulting from road traffic crashes is always a serious problem .', 'Road accidents have become a serious social problem .', 'Road traffic accidents ( RTAs ) represent a serious problem globally causing losses in many ways .', '[ Motor vehicle accidents , a serious health problem in Mexico City ] .', 'Road accidents are a serious problem of the modern world .', 'Road traffic injuries are a serious public health problem worldwide .', 'Traffic accidents as a serious health problem in selected developing countries of the Americas .', 'In Saudi Arabia , road traffic crashes are becoming a serious public health problem and there are no recent , large-scale , published reports discussing maternal and fetal injuries .', 'Based on data that are at best conservative estimates , Nigeria is a country with a serious and growing road accident problem that is about the worst in the world .', 'Disease severity was directly proportional to traffic-accident risk , and thus represents a serious social problem .', 'Despite overall improvements in road traffic safety , pedestrian accidents continue to be a serious public health problem .', 'The study reveals that traffic traumatism continues to be a serious problem for all international community .', 'The disabling injuries inflicted during road traffic accidents ( RTA ) create a serious challenge for the public health services and are at the same time a major socio-economic problem in the majority of the countries throughout the world .', 'Road traffic injury remains a serious public health problem in children and young people in Lithuania , which requires a high priority .']


Cluster  2103
['On the population level , a Rhesus-negativity-associated burden could be compensated for by the heterozygote advantage , but for Rhesus negative subjects this burden represents a serious problem .', 'On the population level , a Rhesus-negativity-associated burden could be compensated for , for example , by the heterozygote advantage , but for Rhesus negative subjects this burden represents a serious problem .']


Cluster  99
['Scar tissue contraction after healing of a burn may be a serious problem .', 'A major factor in burn treatment is early application of skin cells, so allogeneic cells are more appropriate, because these cells are an on-shelf product.', 'The study used prospectively collected and de-identified aggregate data for all burn patients admitted to the burn unit between 2009 and 2014.', 'Plasma oxidants and plasma antioxidant capacity were analysed in 20 superficial partial thickness burn patients for a 2-week period; patients were randomly divided into two groups, one of which was supported with a specifically designed oral antioxidant formula (Squalene 100\u2009mg, Vitamin C 30\u2009mg, Coenzyme Q10 10\u2009mg, Zinc 5\u2009mg, Beta Carotene 3.', 'Burn scars remain a serious physical and psychological problem for the affected .', 'In this study a group of 68 patients hospitalized in the Dr Stanisław Sakiel Centre for Burn Treatment in Siemianowice Śląskie and treated with in\xa0vitro cultured skin cells suspended in platelet-leukocyte-rich gel were analyzed.', 'There were 368 patients with burns (248 with positive cultures, 120 with negative cultures) in this study.', 'Scars are a serious health concern for burn victims and individuals with skin conditions associated with wound healing .', 'The Lund and Browder (LB) chart is currently the most accurate and widely used chart to calculate total body surface area affected by a burn injury', 'In this study, 95 patients with a total of 190 burn wounds were treated with either rhGM-CSF or placebo, separated into 2 groups by treatment type.', 'Between March 2016, and September 2016; 40 patients with burn blisters greater than 6-mm were enrolled in our study.', 'Burn scars are a serious psychological and physiological problem for affected individuals .']


Cluster  1263
['The Glottic view was improved in all patients when using the Airtraq video laryngoscope, compared with Macintosh laryngoscope.', 'Choosing the size of the ProSeal laryngeal mask airway in children according to the auricle of the child is valid and practical.', 'Each suture technique was randomly assigned either to the left or the right tonsillar pillars in 28 patients.', 'In particular , the characteristic facial features of CLS , including retrognathia and large tongue , are associated with difficult ventilation and/or intubation , which is a serious problem of anesthesia management .', 'Patients with Treacher Collins syndrome pose a serious problem to anaesthetists in maintaining their airway because of retrognathia .', "The size of the ProSeal laryngeal mask airway in children is determined by the patient's weight.", 'ProSeal laryngeal mask airways (PLMAs) are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies.', 'The aim of this study is to introduce pterygomandibular suspension suture as a simple modification of uvulopalatopharyngoplasty for severe obstructive sleep apnea in dealing with lateral pharyngeal wall and retropalatal space collapse', '75 patients undergoing elective surgery under general anesthesia and whose direct laryngoscopy by a senior anesthesiologist exhibited Cormack-Lehane grade 2b, 3 or 4 were enrolled.', 'Choking is a serious problem in pharyngoesophageal reconstruction , which may occur following tumor ablation of the pharynx or following corrosive injury involving the epiglottis and other parts of the upper airway .', 'Compromise of the airway is a preventable cause of patient death and is of vital concern to the dental professional .', 'In the administration of face mask ventilation, NIPARA is an effective device that significantly improves the tidal volume administered in edentulous patients.', 'Acute blunt laryngeal trauma can be a life-threatening event and often poses a difficult airway management problem .', 'In anesthetized adult patients with MILS compared with Macintosh, Airtraq provides equal success rate of intubation, statistically significant (although clinically insignificant) longer duration for laryngoscopy and intubation.', 'The successful intubation rates of the Airtraq®, McGrath®, and Macintosh laryngoscopes were 100%, 72%, and 45%, respectively.', 'Our study showed that both laryngeal mask insertion and tracheal intubation can be performed with a stereotactic headframe in situ.', 'In children with challenging airways, GlideScope<sup>®</sup> video-laryngoscopy resulted in a significant improvement of the glottic view with an excellent success rate and satisfactory time to intubation.']


Cluster  1578
['The prevalence of obesity in the United States is a serious health concern .', 'Obesity is fast becoming a serious health problem worldwide .', 'Morbid obesity is a serious health problem associated to a significant reduction in life expectancy .', 'Obesity is a serious health problem with a rather difficult treatment and prevention .', 'Obesity is a severe public health problem worldwide .', 'Obesity is a serious health problem in the US and is associated with increased risks of various human diseases .', 'Obesity constitutes a severe public health problem due to both its complications as a morbid entity and its association to different chronic diseases .', 'Obesity is becoming a serious problem , especially in industrialized societies .', 'Obesity is a serious public health problem within the United States .', 'Obesity is a serious and increasing public health problem in the UK .', 'Obesity is a serious problem for both the individual and society due to its health and economic consequences .', 'Obesity is a serious health problem that leads to serious physical and psychological problems .', 'Obesity is a serious health problem in adults and children worldwide .', 'Obesity is a serious public health problem associated with increased morbidity and mortality .', 'Complications of obesity represent a serious socioeconomic problem .', 'Obesity has become a severe health problem in the world .', 'Obesity is a serious public health problem and being multifactorial is difficult to tackle .', 'Morbid obesity is a serious health problem associated with disease and mortality .', 'With the improvement of living standards , obesity has become a serious health problem all over the word .', 'Obesity is a serious health problem and its prevalence has increased over the years .', 'Obesity has become a serious health problem .', 'Increasing obesity is a serious public health as well as economic problem .', 'Obesity remains a serious public health problem .', 'Obesity is a serious global health problem .', 'Obesity is a serious medico-social and economic problem .', 'Obesity is a serious public health problem , especially in some minority communities , and it has been associated with an increased risk of cardiovascular diseases .', 'Obesity has become a severe public health problem worldwide .', 'Obesity constitutes a serious health problem .', 'Obesity is a serious health problem worldwide .', 'Obesity has become a serious health problem worldwide .', 'Obesity has become a serious public health problem .', 'Obesity is a serious health problem , and its prevention is promoted through life style including diet and exercise .', 'Obesity is a serious health problem in nearly all regions of Europe .', 'Obesity has become a serious worldwide public health problem .', 'Obesity is a serious health problem , and is becoming increasingly common in affluent societies .', 'However , obesity remains a serious growing concern .', 'Obesity is a serious medical problem worldwide .', 'Obesity is a serious public health problem having a direct impact on physical and psychological health of individuals .', 'Obesity is a serious health problem throughout the world .', 'Recent increases in the number of obese individuals and individuals suffering from lifestyle-related diseases , such as type 2 diabetes , that accompany obesity have become a serious social problem .', 'Obesity has become a serious problem in the United States .', 'Obesity is a pandemic and a serious global health concern .', 'Obesity is a serious and highly prevalent health problem .', 'Obesity is a serious problem in our century .']


Cluster  483
['Non-adherence in seniors with dementia - a serious problem of routine clinical practice .', 'Population aging will lead to a dramatic increase in dementia prevalence, which will disproportionally affect racial minorities', 'Dementia is a devastating personal tragedy , a cause of tremendous family strife , and a significant societal dilemma both medically and economically .', 'Dementia is a serious , chronic , and costly public health problem .', 'Dementia among elderly is a serious problem worldwide .', 'Dementia is a serious public health problem .', 'People with a migration background are vulnerable to dementia', "Getting lost ( GL ) is a serious problem for people living with Alzheimer 's disease ( PwAD ) , causing psychological distress in both PwAD and caregivers , and increasing the odds of being institutionalized .", 'Dementia is a serious and growing health problem , and since most people with dementia live at home , caring responsibilities generally fall on family members .', 'Dementia is fast becoming a serious public health concern .', 'Dementia is a serious and growing public health problem in the United States .', "As Australia's aging population increases and diversifies, there will be a growing need to address the burden of dementia among culturally and linguistically diverse (CALD) communities", 'In a randomized, controlled trial, 63 family members caring for persons with dementia were aided by specially qualified family companions (experimental intervention) or by conventional care companions (control intervention).']


Cluster  158
['Needle stick injuries (NSIs) are preventable hazards that can be avoided with appropriate staff training and safety systems', 'Personal protective equipment (PPE) compliance is important to reduce the rate of transmission of virulent pathogens to health care workers', "Interventions aimed at reducing the risks of healthcare-associated infections need to focus on strategies that address: hand hygiene compliance; the handling of materials, equipment, work clothes and surfaces; the effects of interruptions in care activities if they are to alter healthcare personnel's infection prevention behaviour sufficiently.", 'As infection prevention care significantly improves clinical efficacy and reduces the occurrence of complications, it uses in clinic is warranted.', 'Needlestick injuries among health care workers in Taiwan continue to pose a serious occupational problem .', 'Sharps injuries continue to be a serious concern for all healthcare workers .', 'Injuries associated with the category of dental surgical instruments known as " sharps " ( i.e. , syringe needles , glass , scalpel blades , dental burs , and hand instruments ) are a serious concern for dental professionals because of the possible transmission of communicable diseases such as tuberculosis , hepatitis B virus , hepatitis C virus , and human immunodeficiency virus ( HIV ) .', 'Device-related pressure injury ( DRPI ) is a serious problem that is affecting professionals working on the front lines against COVID-19 due to the prolonged use of personal protective equipment ( PPE ) .', 'The use of gloves for every patient contact (ie, universal gloving) has been suggested as an infection prevention adjunct and alternative to contact precautions.']


Cluster  842
['Adhesion formation is a serious problem in peripheral nerve surgery , frequently causing dysfunction and pain .', 'Positioning during neurosurgical procedures is a challenge for surgical teams even if precautions are taken, the mechanisms underlying peripheral nerve injury (elongation, compression or ischaemia) are latent and it is important to know the frequency of occurrence in our environment.', 'This brings a serious problem to the neurosurgeon once the placement of a clip at this place will increase the bleeding .', 'iArmS allows continuous precise manipulations that provide high-quality surgical results in neurosurgical techniques.', 'The sparing of nerves during surgical procedures is a vexing problem because surrounding tissue often obscures them .', 'In some areas of the world the next generation of neuro-surgeons is facing a serious problem .', 'The inability to rapidly restore the loss of function that results from severance ( cutting or crushing ) of PNS and CNS axons is a severe clinical problem .']


Cluster  94
['Although conventional hemorrhoidectomy proved effective in treatment of hemorrhoidal disease , postoperative pain remains a vexing problem .', 'To investigate the effect of preoperative bowel preparation for patients undergoing spinal fusion surgery.', 'Anal post-operative pain is one of the principal issues of surgical treatment of hemorrhoids and remains a distressing problem , for patients and physicians .', 'HA/CMC instillation during laparoscopic radical cystectomy may reduce the incidence of postoperative adhesive bowel obstruction without adverse effects.', 'This study was designed to compare the surgical outcomes of haemorrhoidectomy performed by the Ligasure, Harmonic Scalpel with that performed by the conventional diathermy.', 'This randomised study found no benefit from bowel preparation before major spine surgery on gastrointestinal function.', 'None of the patients who received HA/CMC instillation experienced postoperative adhesive bowel obstructions, compared with six (15.']


Cluster  1026
['Genetic predisposition/hereditary disorders , obesity , smoking , various nephrotoxic industrial chemicals , drugs and natural/manmade radioactivity all contribute and enviromental risks are a serious concern in terms of prevention and the need to screen populations at risk .', 'A major mission for organizing the series of International Conferences on Environmental Mutagens in Human Populations is to bring science and scientists to the sites where the field of environmental health is in developmental stages and environmental health is a serious concern .', 'This increase may ultimately facilitate the initiation of carcinogenic processes at a young age , highlighting a serious public health problem .', 'The hazard quotient ( HQ ) and lifetime cancer risk ( LCR ) estimated from dietary exposure of these vegetables were above the acceptable limit and can be considered as a serious concern for Delhi population .', 'Diffuse carcinogenic risks , that is , those of low potency involving large areas of population and sometimes all mankind , pose a serious public health problem .', 'The possibility that a demonstrated lung carcinogen may be present in large numbers of homes raises a serious public health concern .', 'Our results suggested a serious concern about its potential effects on biological life and related disease inductions .']


Cluster  2291
['Time to pass the VC was significantly shorter with oral insertion compared with nasal insertion (median 24.', 'The intravenous insertion time ranged from 45\xa0seconds to 125\xa0minutes.', 'To determine whether estimating ETT insertion depth using the vocal cord guide rather than weight results in more correctly positioned ETT tips.', 'The modified tongue depressor-aided technique is superior to the digital manipulation and introducer tool techniques for ProSeal LMA insertion.']


Cluster  1930
['These results raise a serious ethical dilemma regarding the use of sham-controlled trials .', 'With the move to start the vaccination program against the threat of Covid-19 , faking Covid-19 diagnostic testing certification pose a severe problem to matters of ethics and economics . If not taken seriously , falsifying documents that certify a person who has undergone Covid-19 vaccination could also happen .', 'Deceit and fraud in medical research is a serious problem for the credibility of published literature .', 'Despite the existence of codes of ethics , research misconduct remains a serious problem .', "The potential problem with placebos is that they may involve deception : indeed , if this is the case , an ethical tension arises over the patient 's autonomy and the physician 's requirement to be open and honest , and the notion that medical care should be the primary concern .", 'This study aimed to investigate the consequences of deceptive placebo analgesia in terms of ethical/psychological effects and efficacy.']


Cluster  1580
['Hypertension is a clinical disease with a prevalence sufficiently high in acculturated societies to warrant it being designated a serious public health problem .', 'Arterial hypertension is a serious health problem .', 'Due to its frequent occurrence in diabetics , hypertension is a serious problem from the aspect of its effect on cardiovascular morbidity and mortality .', 'Hypertension is a serious global public health problem that affects a large part of the Brazilian adult population and can cause limitations and losses of quality of life .', 'Hypertension is a serious public health problem worldwide .', 'Hypertension is a serious world-wide health problem as it increases cardiovascular atherosclerotic risk , stroke and attending morbidity and mortality .', 'Hypertension is considered a serious health problem worldwide .', 'Twenty obese prehypertensive men (age: 20±1.', 'Inadequate blood pressure ( BP ) control remains a serious concern worldwide .', 'Arterial hypertension is a serious public health problem because of its frequency and poor management .', 'Immune responses are involved in arterial hypertension.', 'Hypertension is a serious public health problem in many societies due to its high prevalence and the associated increases in the risks of cardiovascular and renal disease .', 'In Venezuela , hypertension is a serious public health problem exacerbated by age and overweight .', 'Hypertension ( HTN ) and its cardiovascular complications such as stroke and heart failure are a serious public health problem around the world .', 'Essential hypertension is considered a serious health problem and diet can play an important role in its prevention and treatment .', 'Hypertension represents a serious problem in Romania , as there are over 3 million hypertensive people in our country .', 'Although high blood pressure and related risk factors were formerly a serious problem in Japan , blood pressure levels have decreased in schoolchildren from Iwata over the past 15 years .', 'Hypertension ( HTN ) continues to be a serious public health problem in the United States and is a major risk factor for stroke , heart failure , myocardial infarction , and other serious cardiovascular and renal diseases .', 'Hypertension is one of the most important causes of cardiovascular and renal morbidity and mortality , and it represents a serious health problem in Western countries .', 'Hypertension ( HTN ) is a serious and often unrecognized health problem among batey residents .', 'Hypertension is a serious medical problem affecting millions of people worldwide .', 'Arterial hypertension remains to be a serious problem with considerable morbidity and mortality worldwide in the present age .', 'Arterial hypertension is a serious health problem affecting mainly the elderly population .', 'Hypertension represents a serious public health problem and is one of the most frequent causes of morbidity around the world .', 'Obese subjects often have hypertension and related cardiovascular and renal diseases , and this has become a serious worldwide health problem .', 'Hypertension is a serious public health problem .', 'High blood pressure ( BP ) is a serious , common and growing global public health problem .', 'Hypertension is a serious global health problem .']


Cluster  1040
['This is a retrospective analysis of linked health data for adults aged 50 to 69 in 2004 who resided in British Columbia, Canada, between 2004 and 2013.', '1414 Swedish registered physicians in psychiatry or general practice (24% response rate)\xa0completed the survey.', 'From the Swedish National Patient Registry.', 'STROKESTOP was carried out in two Swedish counties with a total population of 2.', 'The results of the German cohort of a pan-European study are presented.', 'Data were gathered from a population-based survey of the German population aged 65 and above in 2015 (n\xa0=\xa01006).', 'The Gutenberg Health Study (GHS) is a population-based cohort aged 35-74 years.']


Cluster  177
['Results suggest that feelings of distress are to be expected from individuals with PTSD and FEP during trauma-focused treatment.', 'Semi-structured interviews were conducted with eight participants (age 18-27 years) with co-morbid PTSD and FEP, after completing a trauma-focused intervention.', 'Fifty participants with psychosis and childhood trauma history were recruited and randomized to take part in either eight sessions of group-based ACT, or to be on a waiting list for the ACT group (i.e. treatment as usual group).', 'ACT offered in a group format appears to be a promising treatment for those with psychosis and history of trauma regardless of trauma severity.', 'Comparable trajectories were found for symptoms of PTSD and anxiety over time.', 'The results indicate that participants experienced significant reductions in PTSD and dissociative symptomatology above and beyond similar treatments of a shorter duration.', 'Although Acceptance and Commitment Therapy (ACT) may be effective for individuals with psychosis and a history of childhood trauma, little is known about predictors of treatment response among such patients.', 'Participants (N\u2009=\u2009124) completed the PTSD Checklist, the Depression and Anxiety Stress Scales and the Personal Wellbeing Index at the start and end of a 4-week Trauma Focused CBT residential program, as well as 3- and 9-months post-treatment.']


Cluster  2210
['Particularly , in Japan , the nursing shortage is a serious problem .', 'Although there is an abundance of research that examines the impact of short-term study abroad on students, there is limited research that examines the impact on the host community and even fewer articles that focus on host communities in relation to the nursing discipline and nursing students', 'For foreign nurses , the practice is often an opportunity to make a better life for themselves and their families . And it helps solve a serious problem for the U.S. organizations involved . But the recruitment of foreign nurses raises a number of ethical questions .', 'A serious shortage of registered nurses at four hospitals in the Moira Shire in northern Victoria resulted in these communities forming the Moira Nurse Education Consortium to address this problem .', 'The faculty nursing shortage has been cited as a reason that qualified students are not admitted to nursing programs', 'The recruitment of Denver-metro skilled nursing facilities was facilitated by key stakeholders of the skilled nursing facilities community.', 'With the global population growth of older people, health care needs nurses interested in caring for this population.']


Cluster  303
['In this pilot study, IPT was offered to 24 depressed women following their first or second contact with the justice system.', 'Results suggested the possibility that WF-CBGT may be a feasible and promising intervention for Japanese workers on leave due to depression regardless of cross-cultural differences, but that additional research examining effectiveness using controlled designs and other samples is needed.', 'The outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians.', 'A pre test- post test control group design was adopted with a sample size of 40 (20 subjects randomized to both experimental and control group) women inpatients diagnosed with depressive disorder at a tertiary care centre, Bengaluru, India.', "At post-treatment, intent-to-treat analyses revealed a significant improvement associated with a moderate effect size on the primary outcome of self-harm frequency (51%, reduction; Cohen's d=0.", 'At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.', 'The study findings support that add-on aerobic exercise is associated with significantly greater improvements in mood symptoms of women with depressive disorders, when performed in a structured and supervised setting.', 'CBT was significantly more effective than IPT in reducing depressive symptoms over the 10 month study largely because it appeared to work more quickly.', 'This study demonstrated the effectiveness of IMR in helping Asian people with mental illness to not only reduce symptoms and hospitalisations but also improve social functioning.', 'This study investigated the impact of a single session of BA on depressive symptomatology, self-reported avoidance, and behavioural approach and avoidance tendencies.', 'Mania and depression scores significantly improved over the course of the study for study completers (ie, 60%-68% improvement for manic symptoms and 41%-49% for depression symptoms).', 'The findings indicated that both therapies were effective in the management of depression.', 'Our aim was to gather preliminary data on whether individual interpersonal psychotherapy (IPT) is an acceptable and effective treatment for depression in women at an early stage in the justice system.', 'To conduct a pilot study of behavioural activation in groups (BAG) for depression delivered in a routine service setting, in order to explore acceptability, effectiveness and predictors of outcome.', "The parametric test of analysis of covariance, followed the intent to treat analyses, revealed the unified protocol significantly changed depression symptoms (Cohen's d\u2009=\u20091.", 'This pilot study investigated the initial efficacy of a work-focused cognitive behavioural group therapy (WF-CBGT) for Japanese workers on sick leave due to depression.', 'It has been suggested that the behavioural activation (BA) treatments for depression unfold their effects, at least partly, through changes in approach and avoidance tendencies.', 'Forty-six patients with a diagnosis of Major Depression were recruited from primary care psychological therapies services and block randomized to either a single session of behavioural activation (n = 22) or waiting list control (n = 24) delivered by an unblinded therapist.', 'A cluster randomized trial will be conducted on sample of 360 students to assess the depression literacy and stigma towards depression before and after a designed intervention educational program.']


Cluster  1792
['Internet addiction ( IA ) is currently becoming a serious mental health problem .', 'Internet addiction ( IA ) among adolescents is a serious public health problem around the world .', 'Internet addiction has become a serious behavioral health problem in Asia .', 'Internet addition disorder ( IAD ) is currently becoming a serious mental health problem among Chinese adolescents .', 'Internet addiction is a serious problem , and the incidence has increased significantly in recent years .', 'The spread of these games through the internet and social networks is becoming a serious health problem facing physicians and medical professionals every day , especially in the ED ; for this reason , it is necessary to be aware of the risks represented by such behaviors in order to recognize and identify preliminary symptoms and develop useful prevention programs .', 'Problematic online gaming ( POG ) and problematic Internet use ( PIU ) have become a serious public mental health problem , with Internet gaming disorder ( IGD ) included in " Conditions for further study " section of DSM-5 .', 'Internet addiction is a serious problem with a profound impact on mental health .', 'Internet addiction is a serious problem that can negatively impact both the physical and mental health of individuals .', 'School teachers have a possibility toward at-risk Internet addiction (IA) due to increased opportunities to use the Internet, along with the spread of the Internet in recent years', 'The number of internet users is increasing rapidly and internet addiction among adolescents has become a serious public health problem in Korea .', 'The results of the study are in accordance with our previous findings on Internet use and mental health , confirming that Internet addiction is a potentially a serious public health problem .']


Cluster  1789
['A major problem with this system , however , is that at the time cells differentiate , they lyze the collagen gel upon which they grow , resulting in termination of the culture .', 'A major drawback of this strategy is the incapability of detecting rapidly occurring cellular responses .', 'The presence of the latter in the cell culture is considered to be a drawback of the cell model .', 'A noticed drawback of these cells in response to tissue injury is the low efficiency of homing .', 'A major drawback of an in vitro system is the lack of multiple organ interactions as observed in a whole organism .', 'However , a drawback of these cells is the incalculability of attachment to the culture dish .', 'However , a major drawback of EV-based therapeutics is scale-up issues due to extensive cell culture requirements and inefficient isolation protocols .', 'However , a problem with this approach is that the cell sorting procedure subjects cells to stresses that may distort their metabolism .', 'However , the colabeling of adjacent cells is a drawback of the technique .']


Cluster  209
['These results provide useful information about the emergent transfer system for patients with large vessel occlusion in a densely populated urban area.', 'To evaluate hard tissue volume stability during the healing stage of GBR with particulate bone graft and resorbable collagen membrane.', 'The two groups showed comparable hard tissue augmentation with minimal reductions in the grafted volume, as well as in vertical (1.', 'We performed a prospective observational cohort study including 30 patients who underwent soft tissue reconstruction.', 'Autologous fat is a good option in many patients with the major drawback of unpredictable longevity , which may require a secondary procedure .', 'Patients reconstructed with autologous tissue have higher levels of satisfaction than those reconstructed with implants.', 'Accuracy of meniscal sizing is an important issue before allograft transplantation.', 'We found The Oberlin transfer is a useful salvage procedure and most effective results are for young patients with short interval between injury and operation.', 'Unpredictability in graft retention remains a significant drawback of fat grafting .', 'Thirty patients undergoing free (n = 20) and pedicled (n = 10) tissue transfer were included in this study.', 'Clinical use of autologous fat grafts for facial soft-tissue augmentation has grown in popularity in the plastic surgery community , despite a perceived drawback of unpredictable results .', 'No superiority is observed for Flex 19G in histological tissue core procurement rate.', 'Patients who also have insufficient soft tissue in the gluteal donor site and preference to avoid an implant , present a vexing problem .', 'All patients operated on by meniscal allograft between January 2005 and May 2015 were screened.']


Cluster  993
['Respiratory fungal infection is a severe clinical problem , especially in patients with compromised immune functions .', 'Invasive fungal sinonasal disease is a life-threatening problem in immunocompromised children , especially with relapsed leukemia .', 'Recently , with increasing medical practices , including organ transplantation and tumor chemotherapy , fungal infections , particularly the occurrence of drug-resistant fungal strains , remain a severe problem for the public health , which cause worse complications in the immunocompromised patients .', "Fungus infection in hematologic cancer patients was a serious problem in the two periods , but it became more important in the late 1980 's .", 'In recent years , fungal infections have become a serious health problem .', 'Fungal infections are still underappreciated and their prevalence is underestimated , which renders them a serious public health problem .', 'The emergence of new fungal pathogens and the resurgence of mycotic diseases that had previously been uncommon is a serious and growing public health problem .', 'Rare and emerging opportunistic fungal pathogens are a serious and growing concern for immunosuppressed patients .', 'Fungal infections are a serious health problem .', 'Invasive fungal infection ( IFI ) is a serious problem due to difficulties in early diagnosis and high mortality .', 'Over the last few years , fungal infections have emerged as a worrisome global public health problem .', 'Infections caused by filamentous fungi are rising in incidence and became a serious health concern .', 'Invasive fungal infections , a serious problem among cancer patients , are increasing in incidence , and can cause morbidity and mortality .', 'Fungal infections have became a serious medical problem due to their high incidence and mortality .', 'Fungal infections remain a serious problem worldwide that require effective therapeutic strategies .', 'Fungal infections represent a serious problem for patients with immune systems compromized either by HIV infection , or administration of immunosuppressive drugs during cancer therapy and organ transplantation .', 'Emerging infectious diseases ( EIDs ) are a severe problem caused by fungi in human and plant species across the world .', 'Fungal infection is a severe problem in children suffering from cancer .']


Cluster  1258
['102 procedures in 60 patients were included.', 'There were 108 patients who were assessed for eligibility, and 101 patients were analyzed.', 'The overall incidence of mucositis was 96.', '101 patients were included.', 'We evaluated 130 polypectomies.', 'Two hundred and thirty-six patients were included; 101 patients underwent PHEA.', 'Sixty-three patients were included with 92 procedures.', 'The study included 1018 eligible subjects in ICUs from 156 hospitals.', 'During the observational period, 94 subjects contracted CAP.']


Cluster  1600
['Radiation-induced dermatitis is a debilitating clinical problem in cancer patients undergoing cancer radiation therapy .', 'Radiation-induced skin injury remains a serious concern during radiotherapy .', 'Radiation-induced skin injury is a serious concern during radiotherapy .', 'However, CLX was unable to reduce the dermatitis caused by ionizing radiation; it significantly reduced itching and pain in patients during radiotherapy.', 'Skin injuries caused by burns or radiation remain a serious concern in terms of clinical therapy .', 'Radiation therapy is widely used for the treatment of various types of cancers ; however , radiation-induced skin injury remains a serious concern .', 'Radiation-induced skin injury remains a serious concern for radiation therapy .']


Cluster  2015
['This was an observational, controlled clinical study including patients with psoriasis (n = 12, mean ± SD age 61·4 ± 4·1 years, 83% men, mean ± SD Psoriasis Area Severity Index score 14·5 ± 4·3) and matched controls (n = 23, mean ± SD age 60·4 ± 4·5 years, 87% men).', 'This was a case-control study based on drug prescriptions derived from a Dutch general practitioner database where patients with psoriasis and controls without psoriasis were matched 1 : 1 for age, sex, general practitioner and duration of follow-up, between 2002 and 2012.', 'Altogether 178 patients were included, of whom 44% had moderate-severe psoriasis.', 'As psoriasis increasingly gains recognition as a serious chronic autoimmune skin disease with long-term impairment on the life course , and not mainly a cosmetic problem , nurses are highly challenged to develop efficient education to support patient self-management .', 'Our data does not support an association between psoriasis and risk of ACS in the elderly.', 'Patients with psoriasis received more prescriptions for all drugs, regardless of associated comorbidities.', 'Psoriasis patients, each with three fingernails with similar degrees of severity, were randomly recruited for intralesional triamcinolone injection group, 0.', 'To describe and analyse cross-regional variations in the use and access of psoriasis topical therapies.', 'MS-based methods identified 140 proteins differentially expressed in psoriatic SC.', 'Psoriasis is a chronic skin disease.', 'Data were extracted from a prospective psoriasis registry of patients treated with MTX (MTX-CAPTURE).', 'Protein biomarker quantification in psoriatic SC detects key pathophysiological mechanisms and enables noninvasive drug profiling in translational medicine settings.', 'Forty patients with mild-to-moderate scalp psoriasis who fulfilled the inclusion criteria were randomly allocated into two groups.', 'In this post-hoc analysis, statins improved lipid levels and cardiovascular outcomes in patients with and without psoriasis, supporting statin use in patients with psoriasis.', 'Arterial inflammation was increased in patients with psoriasis vs.', 'Psoriatic SC was harvested through repetitive tape-stripping.', 'To quantify patient and dermatologist preferences for improvements in psoriasis symptoms and for increases in the risk of treatment-related serious adverse events.', 'Children with psoriasis were enrolled in this cross-sectional study to obtain Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores.', 'Members of the U.K. Psoriasis Association and U.K. dermatologists with experience prescribing biologics completed a web-enabled discrete-choice experiment survey in which they evaluated efficacy and safety features of biological treatments for psoriasis.', 'Psoriasis severity was associated with diabetes, insulin-resistance, smoking habit and higher cardiovascular risk.', 'In relation to the incidence and nature of this disease , as well as to health care costs , it can be concluded that psoriasis represents not only a serious medicosocial but also an economic and public problem .', 'A cohort of 43 psoriatic patients was subjected to analysis.']


Cluster  1947
['Patient falls constitute a serious problem both for the persons fallen and for the institutions involved .', 'Falls are a serious public health problem , with an estimated 37.3 million falls a year requiring medical assistance .', 'The high frequency of fall accidents is a serious problem in Japan .', 'Inpatient falls , many resulting in injury or death , are a serious problem in hospital settings .', 'Falls are a serious public health problem and possibly life threatening for people in fall risk groups .', 'Patient fall has been a severe problem in healthcare facilities around the world due to its prevalence and cost .', 'Falls during stair descent are a serious problem and can lead to accidental death .', 'Fall events and their severe consequences represent not only a threatening problem for the affected individual , but also cause a significant burden for health care systems .', 'Falls from height , particularly from roofs in Diyarbakir , remain a serious problem in terms of public health .']


Cluster  1242
['To compare the differences in clinical and radiologic outcomes and in complications after 1-level interbody fusion versus multilevel interbody fusion for the treatment of multilevel LDD.', 'A hybrid technique including 1-level interbody fusion and multilevel posterolateral fusion is recommended for patients with multilevel LDD.', 'A total of 100 patients with multilevel LDD were randomized in a 1:1 ratio into the 1-level interbody fusion group or the multilevel interbody fusion group.']


Cluster  1124
['This trial demonstrates ease of placement, removal, functionality and safety of temporary DP electrodes which therapeutically decreases diaphragm atrophy.', 'A range of physiological benefits has been observed in clinical studies but an outstanding problem with FES-cycling is that efficiency and power output are very low .', 'We performed remedē® device replacements in consecutive patients for battery depletion, and documented clinical parameters, longevity, operation procedure, complications, and difficulties.', 'Device-related infection frequently becomes a serious problem after deep brain stimulation(DBS)surgery and DBS device removal is usually the only effective treatment option .', "The longevity of a cardiac implantable electronic device (CIED) depends on how quickly the powers consumed by the device's functions exhaust its usable battery energy", 'We reviewed all medical charts of neuromuscular patients and identified all CIED implantations of pacemakers (PM) or defibrillators (ICD) in patients ventilated using tracheostomy.']


Cluster  505
['However , tool wear is a serious concern in milling titanium alloys , which are known as hard-to-cut materials .', 'Barite sag is a serious problem encountered while drilling high-pressure/high-temperature ( HPHT ) wells .', 'Tin-plating has a serious problem : Whiskers are liable to grow on the surface of tinplates .', 'Surface fatigue in gears remains a serious problem in demanding applications , and its solution will become more pressing with the tendency towards thinner oils .', 'A major drawback of this abutment is that casting inaccuracies in the lost-wax process are difficult to control .', 'A drawback of this process is the process-inherent poor surface finish , which is highly detrimental in materials submitted to fatigue loading situations .', 'Both forms had undesirable qualities ; however , a particular drawback of Form 1 was found in its tendency to convert to Form 2 upon milling .', 'A drawback of this alloy is the fact that β phase , Al3Mg2 , can precipitate on grain boundaries causing sensitization and intergranular corrosion , which is detrimental to the integrity of the structure .', 'However , a serious problem of most superhydrophobic surfaces described in the literature is poor operational durability under harsh corrosive and abrasive loads characteristic of atmospheric operation .', 'These fall in the Mg K-EXAFS region and so can present a serious problem in studies of this edge for a wide range of materials .', 'Casing wear is a serious problem in highly-deviated wells because serious wear will lead to casing deformation , drilling tool sticking and failure of subsequent operations .', 'A drawback of this low-temperature method is that the NWs have a high density of defects , such as stacking faults , dislocations , and oxygen vacancies .']


Cluster  20
["Estimating the subject 's ability to undergo imprisonment and determining whether there are any reasons for delaying or stopping imprisonment , has become a serious problem .", 'The authors examined levels of force used by officers with or without CIT training and disposition decisions in a large sample of encounters with individuals whom they suspected of having a serious mental illness , a drug or an alcohol problem , or a developmental disability .', 'Although there was no demonstrable advantage of R&R2 over TAU alone, non-significant trends towards lower violent recidivism in the R&R2 group and general recidivism in the TAU group suggest that it may be worth repeating the trial in a larger sample with more differentiated control groups.', 'Incarcerated offenders with serious mental illness (N\xa0=\xa0101) were randomly assigned to R&R2 or TAU alone.', 'A randomly selected sample of 1179 participants from the adult sentenced population of Puerto Rico (USA) reported their history of violent and non-violent offences, age of first arrest and re-offending.', 'The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience and mental health among LEOs, as well as yield significant benefits for the communities and residents they serve.', "Estimating the subject 's ability to undergo imprisonment and determining whether there are any reasons for delaying or interrupting the execution of the penalty has become a serious problem .", 'Moving in as a T. police force , being seen by everybody as a increasing the number of features , which can make MERT less stable ( Foster and Kuhn , 2009 )', 'A controlled clinical trial with 85 participants who participated in a 12-week prison-based group anger management programme, of whom 57 (67%: 16 control, 41 intervention) provided pretrial and posttrial outcome data at Times 1 and 2.', 'In contrast to most previous trials of FFT, FFT+MAU did not lead to greater reductions in youth ASB and offending compared to MAU alone, and did not lead to improvements in parenting or the parent-child relationship.']


Cluster  658
['A cross-sectional observational study was conducted.', 'Prospective, longitudinal, observational study.', 'Observational, multicentre, cross-sectional study.', 'Cross-sectional, observational questionnaire study.', 'The study was conducted as an observational cross-sectional study.', 'A quantitative cross-sectional study nested within a randomised controlled trial.', 'Observational, cross-sectional and multicentre study.', 'Cross-sectional, descriptive, observational study.', 'this is a multicenter, cross-sectional observational study.', 'We carried out an observational, descriptive and cross-sectional study.', 'A cross-sectional study was carried out.', 'Cross-sectional observational study.', 'Multicenter, prospective, observational cohort study.', 'This is a cross-sectional, observational study was conducted.', 'A prospective, longitudinal, observational study.', 'Cross-sectional, observational study.', 'We conducted a cross-sectional secondary analyses.', 'Repeated measures, cross-sectional study.', 'this was an observational and cross-sectional study.', 'Observational cross-sectional study: electronic survey.', 'This was an observational, descriptive, and prospective study.', 'A cross-sectional study, part of a randomized controlled trial.', 'Prospective, observational, repeated measures investigation.', 'A questionnaire-based cross-sectional, correlational, observational study.']


Cluster  233
['In a pre-post design, intervention and control samples of college students (n = 53) are compared with regard to distress, protective factors and quality of life.', 'Anxiety disorders are among the most common of all mental disorders and , when coupled with an awareness of the disability and reduced quality of life they convey , they must be recognized as a serious public health problem .', 'Anxiety-related problems at work are a serious problem in the occupational context , as they come along with sick leave and problems in work participation .', 'A growing portion of the population is exposed to emotional stress that results in a high incidence of anxiety disorders , a serious social problem .', 'The oriented group experienced decreased anxiety following the first simulation (p\xa0=\xa00.', 'We describe the successful measures taken by State health workers to counteract the anxiety which itself constituted a serious public health problem .', 'This study uses a convenience sample randomly assigned to a control and intervention group with a pre-pre, pre, post and post-post-test using the Spielberger State-Trait Anxiety Inventory.', 'Thirteen participants were randomized to a weekly 8-session worry intervention group (n = 7) or wait-list control (n = 6).', 'There was a significant reduction in anxiety, depression, and general symptomatology in the experimental group compared to the control group.', 'Nine months after interventions, there was a decrease of anxiety (P=0.']


Cluster  1622
['Chronic liver disorders represent a serious health problem .', 'Liver damage through prolonged intake of high amounts of alcohol is a serious problem that affects many members of the population .', 'Chronic liver diseases are a serious health problem worldwide .', 'Chronic liver dysfunction or injury is a serious health problem worldwide .', 'Liver disease is a serious problem .', 'Liver damage is a serious medical problem worldwide and is caused by primary or secondary metabolic , microbiological , toxicological , immunological and circulatory etiological factors .', 'Alcoholic liver disease ( ALD ) is a serious liver problem in western countries .', 'Liver failure is a serious problem that affects thousands of people in the United States each year .', 'Hepatic foci are a serious economic problem for most turkey-producing areas in the United States .', 'Liver injury or dysfunction is considered as a serious health problem .', 'Human liver cancer has emerged as a serious health concern in the world , associated with poorly available therapies .', 'Hepatic cirrhosis is a serious clinical problem caused by the accumulation of extracellular matrix , which can ultimately progress into hepatic failure .', 'Alcoholic hepatitis is a serious clinical problem ; opportune detection is transcendental for treatment and survival improvement .', 'Liver disease , involving a wide range of liver pathologies from fatty liver , hepatitis , and fibrosis to cirrhosis and hepatocellular carcinoma , is a serious health problem worldwide .', 'The prevalence of various hepatic diseases increases dramatically worldwide and regarded as a serious health problem .', 'Hepatic sickness is a serious problem for human health .', 'Chronic liver disease is a serious global health problem , and an increasing number of patients are seeking alternative medicines or complementary treatment .', 'Liver injuries have been a serious public health problem worldwide .', 'Chemical liver and kidney injury have become a serious concern to human .', 'As a serious public health concern , alcohol-related liver disease is associated with dysregulations in the intestinal barrier function and the gut microbiota .']


Cluster  22
['A total of 21,162 patients were randomized and followed for 33\xa0months (median), with 28% of patients ≥5\xa0years from MI at trial conclusion.', 'We enrolled 96 patients in this randomized controlled trial.', 'One hundred patients were recruited to this prospective, randomized trial.', 'We randomized 250 patients.', 'In total, 72 patients were randomized to intervention groups.', 'This randomized clinical trial was conducted with 100 patients.', 'From May 2006 to May 2009, 86 patients entered the study and 72 (84%) completed the 5-year protocol.', 'In total, 198 patients were randomized and 175 patients completed the trial with a mean age of 49.', 'Before LCE, 263 patients were randomized into the control and test groups.', 'Some 245 patients were randomized within the trial, and followed up for a median of 19 months.', 'Two hundred forty patients were randomized.', 'A total of 100 healthcare professionals were enrolled as participants in this randomized trial.', 'This randomized controlled trial involved 72 patients with CAS.', 'Nineteen patients enrolled in the trial, and 18 completed all safety and efficacy measurements.', 'Over a 3-year study period (2011-2014), we could identify 91 patients satisfying study criteria.', 'A total of 726 patients were randomized to TachoSil (n = 361) or current practice (n = 365).', 'Eighty-six patients were randomized (42 in ELC and 44 in DLC group).', 'Thirty patients were randomized into two groups.', 'Seventy-six patients were divided into 2 randomized groups.', 'A prospective nonrandomized controlled multicenter trial included 130 patients.', 'Three hundred patients were randomized, 150 in each group.', 'A total of 92 patients were randomized to 39 in the waiting group and 53 in the control group.', 'Twenty-nine patients were successfully enrolled in the study; 27 (93.', 'Patients were randomized to PC versus DC.', '700 patients were randomized.', 'This randomised control trial (RCT) included 21 closed Sanders type 2 and 3 DIACFs which were selected from 70 who presented.', 'A prospective randomized study was done in 114 patients with CBDSs who met inclusion criteria.']


Cluster  824
['Continued administration of famotidine results in a diminished effect on intragastric pH in dogs.', 'A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate .', 'Continued administration of famotidine resulted in a significant decrease in mean pH, MPT ≥3, and MPT ≥4 (P < .', 'One problem often cited as associated with salicylic acid is that it can be quite irritating at pH 3 - 4 , where it exhibits the highest activity in the treatment of skin diseases .', '[ Is tetracycline induced discoloration of the teeth really a serious problem ? ] .', 'A major drawback of the antibiotic erythromycin A is its extreme acid sensitivity , leading to rapid inactivation in the stomach .']


Cluster  264
['Midwife-led care can reduce the caesarean section rate, promote normal birth, improve birth outcomes, and promote maternal and child health.', 'There is increasing evidence throughout the world that the negative treatment of pregnant women during labor and delivery can be a barrier to seeking skilled maternity care.', "To discover the mechanisms affecting midwives' ability to work to full scope of practice after completing a programme of study leading to endorsement.", 'Midwifery programs leading to registration as a midwife in Australia have undergone significant change over the last 20 years', 'The problem of early motherhood is still a serious medical and social problem in many countries around the world .', "To describe and compare uniformity in couples' birth experiences of the quality of intrapartum midwifery care.", "This longitudinal observational study included 836 parous woman recruited at women's health centres and natural birth communities in Israel.", "Midwives can enhance couples' feeling of being in control during labour and birth by being attentive, present and continuously providing adequate information and emotional support.", 'Continuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies', 'Through the use of a local birth evaluation form at a Swedish labour ward, 190 women gave written evaluations of their birth experiences.', "Longitudinal observational study including 342 first-time expectant mothers recruited at women's health centres and natural birth communities in Israel.", "To measure time spent on clinical documentation and nurses and midwives' perceptions of this aspect of their role.", "women 's underutilisation of professional care during childbirth in many low-income countries is a serious concern in terms of achievement of maternal Millennium Development Goal 5 ."]


Cluster  508
['NB-UVB treatment is highly effective and leads to a remarkable reduction in the need for topical cream treatments for a period of at least 12 months.', 'A short course of tirbanibulin ointment 1% safely reduces AK lesions.', 'Topical tacalcitol enhances the therapeutic effects of NBUVB therapy and exerts a UVB-sparing effect, without increasing the incidence of adverse effects.', 'Three adjacent areas of cutaneous CM that had never been treated before were selected in each patient and underwent the following regimens: (A) PDL\u2009+\u2009vehicle for 8\u2009weeks post-PDL; (B) PDL\u2009+\u2009topical rapamycin for 1-week post-PDL and (C) PDL\u2009+\u2009topical rapamycin for 8\u2009weeks post-PDL.', 'Low-dose isotretinoin was effective in managing papules and nodule lesions (p < .', 'To investigate the safety, tolerability and pharmacokinetics and assess indicative efficacy of a novel antibody ointment as a therapeutic for basal cell carcinoma (BCC).', 'An open-label, phase I clinical trial was undertaken at three dermatology clinics to evaluate the safety and tolerability of topical administration of an ointment containing 10% sheep polyclonal anti-nfP2X<sub>7</sub> antibodies (BIL010t) to primary BCC lesions twice daily for 28 days.', 'We evaluated the effect of combined use of 1% topical rapamycin with PDL compared to PDL alone in cutaneous CM of trunk or extremities and tried to identify the optimal duration of topical rapamycin application.', 'Microphototherapy is indicated in patients whose lesions persist despite systemic and topical treatment or when such treatment is contraindicated.', 'In the Phase 1 study, 4 treatment cohorts with forearm lesions received tirbanibulin ointment 1% over 25 or 100 cm2 once daily for 3 or 5 days and were evaluated through day 45.']


Cluster  1362
['We conducted an observational study of all ERCP conducted in an endoscopy unit with an on-going training program.', 'Some patients may experience retrosternal pain during ERCP , which may be a pioneer of a serious myocardial problem , and early diagnosis is very important for the prognosis and management .', 'Six risk factors for post-ERCP complications were identified.', 'We evaluated the ability of simple easy-to-use optical evaluation criteria to detect the post-EMR scar, with or without tattoo placement, in a prospective observational cohort of LNPCPs referred for endoscopic resection.', 'We studied eight patients with angina pectoris (median [range] age 72 [53-85], 25% women), who underwent EECP for 35 daily sessions.', 'Acutely during EECP, there is an increase in cardiac output that is unrelated to direct EECP effects but related to, and may be secondary to, an increase in peripheral O<sub>2</sub> demand.']


Cluster  1147
['A convergent mixed methods design was used to examine changes following training in 12 participating caregiver students in a Tanzanian orphanage.', 'To construct and validate a robust instrument for assessment of MTB leading and chairing skills.', 'Supervision is an emergent process where knowledge is transformed through interactions and shared sense-making processes.', 'Quantitative results demonstrated that TAE participants achieved strong attendance (99.', 'This study provides empirical evidence for the effectiveness of a classroom-based cognitive training in older primary school children and is of practical relevance for educators.', 'Role-based learning involves the process whereby learners acquire skills, knowledge and understanding through the assumption of roles within real-life settings.', "The use of blended case-centred learning showed promising results in improving students' academic performance.", 'To implement and evaluate a health education programme based on the development of social and emotional competence in young children.', 'The provision of lay support to women with social risk may facilitate infant gross motor skill development at one year but there were no other demonstrable benefits.', 'The relational didactics competencies of the caregiver students improved significantly following their training.', 'CO-OP with and without additional parental coaching resulted in improved occupational performance according to children, parents, and external evaluators.', 'The Walking Classroom is an education program that provides students with an opportunity to accumulate physical activity without losing instructional time', 'Assessment of affective learning (AL) is difficult but important, particularly for health professional students, where it is intimately linked to the development of professional values.']


Cluster  1853
['We can not say that no two constituents may combine when they are separated by a large gap , only that the two smallest possible constituents , i.e. , the two words , may not combine . it is very hard to generalize and introduces a lot of additional redundant relation edges', 'We can not say that no two constituents may combine when they are separated by a large gap , only that the two smallest possible constituents , i.e. , the two words , may not combine . it is very hard to generalize and introduces a lot of additional redundant relation edges', 'We can not say that no two constituents may combine when they are separated by a large gap , only that the two smallest possible constituents , i.e. , the two words , may not combine . it is very hard to generalize and introduces a lot of additional redundant relation edges']


Cluster  2180
['This study suggests that a 6-week course of RIC treatment could improve cardiac function and HRV in patients with mild and stable IHF, supporting widespread use of RIC in the daily lives of these patients.', 'We performed a prospective cohort study involving 249 German resident cardiologists and analyzed the 1-year effectiveness and safety of ivabradine used in CHF outpatients.', 'Ivabradine was effective and well-tolerated in CHF patients seen in clinical practice throughout 1year of treatment.', 'Fifty patients with stable IHF were enrolled and randomly divided into RIC group and control group.', 'In total, 767 CHF patients were enrolled to receive ivabradine twice daily, of whom 684 (90%) were still on ivabradine at study end (mean treatment duration 11.']


Cluster  95
['660 patients were included and followed up for at least 3\u2009months.', 'Seventy-four patients were enrolled in the post-protocol group, and 42 in the pre-protocol group.', '587 patients (295, in first and 292, in second phase) were enrolled.', 'A total of 294 patients were included.', 'A total of 234 patients were enrolled, including 120 (arm A) and 114 (arm B) treated per protocol.', 'Among 6,556 patients who participated in the cohort study from 2011 to 2016, 1,289 patients who completed at least 2 days of 3-day diet diaries were included in this study.', 'Overall, 100 patients had 152 treatment sessions (58, 33, 8, and 1 patients had 1, 2, 3, and 4 sessions, respectively).', 'We studied 202 patients.', 'From February 2015 to March 2016, a total of 288 patients were enrolled, and 274 were included in the per-protocol analysis.', 'A total of 215 patients were included in the 52-week extension study.', '310 patients were included.', 'Of 110 patients, 101 completed the dietary interventions.', 'In total, 311 patients were included.', 'We identified 199 patients that were enrolled for 6 or more years.', 'Of 371 enrolled patients, 324 patients had the weight records from baseline to week 16.', 'Primary care patients n\u200a=\u200a183, who worked.', 'Overall, 201 patients were enrolled.', 'In total, 390 patients from 15 North American centers qualified for inclusion.', 'A total of 200 patients were screened, and 175 patients were enrolled.', 'There were 103 patients included in the pre-SU period, as compared to 186 patients in the post-SU period.', 'Data were collected through observations of 50 MDTMs and from questionnaire data from 206 health professionals that participated in these meetings.']


Cluster  257
['This study suggests that GSE positively affects shoulder stability and pain control in patients with shoulder pain, probably through a centralization effect on the shoulder mechanism.', 'This prospective randomized controlled study included 121 patients presenting with frozen shoulder.', 'To compare the effects of scapular movement training versus standardized exercises for individuals with shoulder pain.', 'The average prevalence of shoulder problems during the season was 17% (95% CI 16% to 19%) in the intervention group and 23% (95% CI 21% to 26%) in the control group (mean difference 6%).', 'Unilateral A-P mobilisation applied to the cervical spine shows a tendency toward positively influencing post-arthroscopy shoulder pain and function.', 'These results suggest that complex exercise is beneficial to improve shoulder range of motion as well as pain of the women with breast cancer-related lymphedema.', 'To compare between single and multiple (nine) SSNB in the treatment of diabetic frozen shoulder.', 'Suprascapular nerve block (SSNB) is used in the management of frozen shoulder.', 'The American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form is one of the most frequently used outcomes score for shoulder pathology', 'This was a single-institution, prospective, randomized controlled trial of male patients undergoing shoulder arthroscopy.', 'Sixty-five shoulder arthroscopy patients were prospectively enrolled.', 'Automated intermittent boluses reduce pain after major shoulder surgery.', '30 patients with a diagnosis of shoulder pain were randomly assigned and examined by 2 musculoskeletal physical therapists at a time.', 'After 4\xa0weeks, complex exercise group had greater improvements in shoulder range of motion and pain compared with the conventional decongestive therapy group (p\xa0<\xa00.', 'Forty subjects with shoulder pain were randomly assigned to an experimental or control group.', 'The horizontal adduction stretch is more effective at reducing acute PST in the postoperative shoulder population when compared to the supine sleeper stretch and no stretch at all.', 'The flexion, abduction, and rotation ROMs were most significantly associated with severity of pain and the physical disability in patients with shoulder dysfunction.']


Cluster  2245
['Radiographic assessment of global sagittal alignment did not fully reflect surgical correction of sagittal balance until 6\u2009mo after adult deformity surgery.', 'The ability of Surgimap to predict proper postoperative sagittal alignment was excellent in this cohort.', 'Retrospective review of a prospective observational database identified a consecutive series of patients with sagittal vertical axis (SVA) > 40\u2009mm undergoing adult deformity surgery.']


Cluster  760
['Usually asymptomatic in immunocompetent humans , toxoplasmosis is a serious clinical and veterinary problem often leading to lethal damage in an infected host .', 'Toxoplasmic encephalitis ( TE ) , an opportunistic infection , is a severe health problem in immunocompromised patients .', "These results suggest that ' asymptomatic ' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health as well as economic problem .", 'Toxoplasmosis , caused by the obligate intracellular protozoan parasite Toxoplasma gondii , has become a serious public health problem worldwide .', 'Infections with the intracellular protozoan parasite Toxoplasma gondii pose a serious public health problem and are of great economic importance worldwide .', 'Toxocara canis and Ancylostoma spp . are geohelmints that parasites dogs and can eventually affect humans , mainly children , causing visceral and cutaneous larva migrans respectively , constituting a serious public health problem .', 'Recently , toxoplasmosis associated with neurological complications as an opportunistic infection is a serious problem in the immunocompromised hosts , especially in AIDS , but this infection is rare in immunologically normal adults .', 'Visceral toxocariasis is a serious public health problem with a cosmopolitan distribution .', 'Accordingly , it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health .', 'Our findings showed that small ruminants of the Multan District in Pakistan are toxoplasma seropositive and may pose a serious threat of public health concern in the region .', 'Toxoplasmosis is a zoonotic disease , recognized as a serious public health problem worldwide .']


Cluster  750
['Childhood obesity persists as a serious public health concern , particularly among Mexican-origin youth .', 'Latino preschool children have higher rates of obesity than children from other racial/ethnic backgrounds', 'This is a longitudinal follow-up of participants of the Growth and Obesity Chilean Cohort Study (GOCS) that represents Chilean children from low- to middle-income families.', 'A range of studies report a robust association between family socioeconomic position and the prevalence of child overweight/obesity', 'Children and adolescents from families with a\xa0migration background and/or low social status belong to risk groups for the development of overweight', 'The increasing prevalence of overweight/obesity among children is a serious problem in the Caribbean .', 'The results confirm that overweight and obesity are a serious public health problem in Portuguese children and adolescents , and urgent measures are needed to suppress this epidemic and reverse the situation as soon as possible .', 'INTRODUCTIÓN : Obesity is a serious public health problem in Mexico , the National Health and Nutrition Survey ( ENSANUT 2012 ) reported a 34.4 % prevalence of overweight , and obesity in children aged 5 - 11 .', 'The association between being overweight/obese and deprivation is a serious concern in English schoolchildren .', 'Excess weight in schoolchildren is a serious health problem in Mexico .', 'Child obesity is a serious problem of public health in México .', 'Childhood obesity is a serious public health problem in Mexico .']


Cluster  398
['Sense of coherence (SOC), and symptoms of anxiety, depression and posttraumatic stress, compared to standard care at 12\u202fmonths after intensive care discharge.', 'Perceived social support at discharge from inpatient care may reduce rehospitalisation rates and psychopathological impairment in the long term.', 'Our study revealed poor rest-activity cycle consolidation among critically ill MV patients during the early ICU period.', 'Lack of perceived social support at discharge significantly predicted subsequent rehospitalisation rates and increased psychopathological impairment across 12-month follow-up.', 'Self-efficacy for managing brain injury-specific symptoms and QoL increased significantly after neuropsychological rehabilitation.', 'Investigation of predictors of cognitive performance for initially ventilated early rehabilitation patients.', 'We found no association between pre-hospital frailty, physical function, strength, or mortality at hospital discharge in critically ill patients enrolled in an early rehabilitation trial.', 'Acuity-adaptable patients reported significantly more anxiety and less perceived emotional care than ICU patients.']


Cluster  827
['Reevaluating patients who are admitted with heart failure (HF) exacerbation using echocardiogram is a common and appropriate indication.', 'A basic blood panel could be a useful tool in assessing patients with heart failure.', 'Congestive heart failure is such a serious problem and the consequences of hospitalization so onerous in terms of patient well-being and costs to society that actual hemodynamic monitoring , despite its costs , is beneficial in carefully selected high-risk patients .', 'PAPi serves as a marker of RV dysfunction and strongly predicts adverse clinical events in patients with advanced heart failure.', 'A total of 59 patients hospitalized for heart failure were randomized to either continuous intravenous infusion (n = 30) or oral medication (n = 29) within 48 h of admission.', 'Data on 9000 patients from the IN-CHF registry show that hospitalizations are a serious problem in Italy : 44 % of the patients had at least one hospitalization for heart failure in the year prior to the entry visit and this is the most powerful independent predictor of rehospitalization during the follow-up .', 'We comparatively analyzed PAPi with traditional indices of RV function including RV stroke work index and right atrial/pulmonary capillary wedge pressure ratio (RAP/PCWP) in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial.', 'A comPrehensive, ObservationaL registry of heart faiLure with mid range and preserved ejectiON fraction (APOLLON) trial will be an observational, multicenter, and noninterventional study conducted in Turkey.', 'Lessons learned from the SNF Connect Trial, a randomized trial of a heart failure disease management versus usual care for patients with heart failure receiving post-acute care in skilled nursing facilities, are discussed.', 'Two hundred and seventy-one consecutive patients, admitted for acute heart failure, were prospectively randomized to NT-proBNP-guided therapy or control group.', 'Although almost half of chronic heart failure (HF) patients have mid-range (HFmrEF) and preserved left-ventricular ejection fraction (HFpEF), no studies have been carried out with these patients in our country.']


Cluster  248
['Typically up to 70 % of ingested protein-N is excreted representing a loss of productivity potential and a serious environmental problem in terms of nitrogenous pollution of lands and water .', 'In contrast with other food proteins , such as β-lactoglobulin or caseins , intensely studied for bioactive peptide production , relatively little attention has been paid to serum albumin , the main blood protein , even though blood disposal is a severe problem for meat processors .', "Participants were randomized into double-blind pHF-pHF and extensively hydrolyzed cow's milk protein-based formula (eHF)-pHF groups.", 'The Na-DHA residue levels in swine tissues were <1.', 'The plasma metabolites revealed different amino acid profiles reflecting the amino acid composition of casein and whey proteins.', 'Na-DHA included at 200\u2009mg kg<sup>-1</sup> in a swine diet is a safe feed additive based on residue elimination and ADI values reported.']


Cluster  231
['Clinical , dietary , and biochemical surveys have shown that on the whole Latin America faces a serious nutrition problem .', 'Introduction : Child malnutrition remains a serious public health problem in Honduras , with a national prevalence according to the World Health', '[ Nutrition :   a serious national problem ] .', 'The critical limitation with the proportional weight gain criterion was that children who are most severely malnourished tended to receive shorter treatment compared to less severely malnourished children .', 'The National Nutrition Survey on Preschool Children, Japan (NNSPC) provides fundamental information for policy making for child nutrition', 'Malnutrition risk was found: 25.', 'Sixteen weeks of nutritional support was associated with statistically significant improvements in weight and a reduction in the proportion of patients who were malnourished.', "Providing practical nutrition lessons in a primary school setting with a high proportion of children with immigrational background improved the children's nutrition-related knowledge and skills.", 'When classifying nutritional status in children with WT, the utilisation of weight and height in isolation can lead to an underestimation of the prevalence of malnutrition.', 'Malnutrition among the indigenous early childhood population is still currently a serious public health problem , and given that no specific studies affording the possibility of knowing the nutritional condition of this population , the question was posed of identifying the prevalence of malnutrition among the indigenous population of Mexico by means of the 1999 National Nutrition Survey .', 'This study aims to explore the prospective association between the dietary quality (DQ) of preschoolers and their health status in Hong Kong, with the body mass index as the main outcome variable', 'Lack of diversity in the diets is a serious problem among poor populations in the developing world .', 'The PO group presented more individuals in the malnourished range (24.']


Cluster  1847
['A major drawback of currently available constrained components is the limited range of motion ( ROM ) .', 'However , a drawback of high robustness is the occurrence of chattering around the control reference .', 'Finally , a novel dynamic quantizer for the control inputs with adaptive step size is designed to eliminate the quantization error overtime , thus overcoming the drawback of the traditional uniform quantizer .', 'Many literatures study various types of external control problems , with a common drawback of ignoring the number of times that external control(s ) can be applied .', "One problem with voice control is that the voice 's limited bandwidth renders it impossible to make frequent small adjustments to the wheelchair 's velocity ."]


Cluster  794
['Ninety-one patients qualified for analysis.', 'This study included 462 patients (male, n=244; female, n=218).', 'One hundred four patients were enrolled in the study (group A, 53; group B, 51).', 'Overall, 279 patients were analysed.', 'Among the 56 randomized patients, 50 (27 PUI vs 23 PUI) produced analyzable data.', 'Data for 52 patients were analysed.', 'From January 2013 to December 2015, 80 patients were included in the study, 40 in each group.', '374 patients were analysed.', 'A total of 101 patients were enrolled in our study (group A: 52; group B: 49).', '207 patients were evaluated and 69 patients (33.', 'We prospectively evaluated 87 patients in 2 centers.', 'Groups A and B consisted of 147 and 148 patients, respectively.', 'During the previously stated period of time, we analyzed the results of 879 patients.', 'In this multicenter, double-blind, vehicle-controlled study, eligible subjects were randomly assigned to receive up to 2 treatments of A-101 40%, A-101 32.', 'Our cohort study of 134 patients and 150 healthy subjects were examined.', 'The study included 669 patients: 79 (11.', 'An observational, descriptive and prospective study in which a total of 490 patients were included.', 'Data of 103 patients were analyzed.', '177/214 patients were analysed (87.', 'A consecutive cohort of 621 patients was included in the study.', 'A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients.', 'A total of 359 patients were assessed and finally 310 patients were analyzed.', 'This was cross-sectional study with 184 patients.', 'A total of 124 patients were enrolled in this observational study.', 'A total of 375 paired datasets from 25 patients were included in analysis.', 'A total of 120 patients participated in the study (NB\u200a+\u200aGA: 61; GA: 59).']


Cluster  135
['However , it does not provide a way to overcome the problem of inaccurate counts for low-probability cooccurrences', 'The main problem with nonlinear models is that product variables are non-normally distributed .', 'However , a drawback of the approach is that the difference images are usually only qualitative in nature and their spatial resolution can be weak because they rely on the global linearization of the nonlinear observation model .', 'A common problem with observational datasets is that not all events of interest may be detected .', 'Unlike the case in product units , the local minima problem does not pose itself as a severe problem in the model .', 'A potential problem with the application of finite mixture models in practice is that these models may drastically overestimate the number of component densities when there is a lack of model fit .', 'Another problem is that frequency is not always useful for detecting mistakes , because the norm can be very separated from real use', 'A problem with this analysis is that random diffusion can appear as correlated motion .', 'The problem was that such probabilities could not be estimated directly from the data due to data sparseness', 'A drawback of the TSM model is the assumption that source and target information is generated monotonically', 'These did not provide an adequate description of system behavior ; subsequent simulation studies showed that the major problem with the Wiener analysis was that the input spectrum was not adequately white .', 'The main drawback to modeling p ( t Is ) in terms of p ( w I h , s ) is that the latter distribution is conditioned on two very disparate sources of information which are difficult to combine in a complementary way', 'The problem with such techniques is that grain borders , light fluctuations , and nonuniform brightness contribute to produce noisy images of concentrations that can not be directly used to estimate mixing at the local scale .', 'One problem with the Witkin model was that it produced a posterior distribution with multiple maxima , reflecting the inherent ambiguity in scene reconstruction under orthographic projection .']


Cluster  1203
['This was a randomised, double-blind, three-period crossover study (ClinicalTrials.gov identifier, NCT03257995) in patients with asthma on background ICS therapy.', 'Severe asthma patients were treated with BT (TASMA trial).', 'In total, 53 patients with symptomatic asthma who received ICS plus LABA and who had a prebronchodilator forced expiratory volume in 1 second of 6090% of the predicted value were randomized to the addition of tiotropium 5 g once daily (n = 25) or no add-on (n = 28) to maintenance therapy for 48 weeks.', 'Compared with maintenance therapy, the addition of tiotropium significantly decreased airway wall area (WA) corrected for body surface area (BSA) (WA/BSA) (p 0.', 'To assess the safety and feasibility of OCT in severe asthma patients and determine acute airway effects of BT by OCT and compare these to the untreated right middle lobe (RML).', 'Once-daily tiotropium Respimat 5\xa0μg improved lung function and was well tolerated as add-on therapy to ICS\xa0with other maintenance therapies in children with severe\xa0symptomatic asthma.', 'In patients with asthma, indacaterol maleate and acetate elicited comparable and significant improvements in lung function compared with placebo and achieved comparable systemic exposure.', 'To evaluate the efficacy and safety of beclomethasone dipropionate BAI and metered-dose inhaler (MDI) versus placebo in pediatric patients ages 4-11 years with persistent asthma.', 'During the bronchiolitis admission of 2479 children who were later hospitalized for asthma, corticosteroid prescription (<i>n</i> = 857) was associated with longer LOS in bivariate analysis (3 [2-4] vs 2 [2-4] days; <i>P</i> < .', 'The use of nebulised magnesium sulphate in moderate asthma exacerbation as adjuvant treatment showed no benefit to standard treatment in our study.', 'We sought to assess the efficacy and safety of once-daily tiotropium Respimat add-on therapy to high-dose ICS with 1 or more controller medications, or medium-dose ICS with 2 or more controller medications, in the first phase III trial of tiotropium in children with severe symptomatic asthma.', 'Bronchial asthma ( BA ) is a serious problem .', 'To ealuate the efficacy, safety, and pharmacokinetics of BI 671800, a CRTH2 antagonist, when added to inhaled corticosteroid therapy in adult patients with symptomatic asthma.', 'Our preliminary findings suggest that the addition of BBT to treatment as usual for children with asthma enhances outcomes with respect to spirometry and parental emotional function but does not lead to reductions in medication, at least over the short term.', 'This prospective, open-label, observational study enrolled 40 adult patients with asthma of mild-to-moderate severity who were started on ICS and 40 healthy controls.', 'In this double-blind, double-dummy, phase III study, 628 children with persistent asthma were randomly assigned (1:1:1:1:1) to twice-daily beclomethasone dipropionate (BAI 80 μg/day, BAI 160 μg/day, MDI 80 μg/day, or MDI 160 μg/day) or to placebo.']


Cluster  2026
['Pressure ulcers are still a serious problem for the hospitalized patient in this country .', 'Pressure ulcers are a serious health problem in medical and nursing care .', 'Pressure ulcers are a serious national health concern impacting cost of care , reimbursement , and quality of life .', 'The data available regarding the epidemiology of pressure ulcers suggest that they are a serious public health problem in the United States , particularly among the elderly .', 'Pressure ulcers remain a serious problem for patients and providers in healthcare .', 'Pressure ulcer is a serious problem during patient care processes .', 'Preventing and treating pressure ulcers will continue to be a troublesome problem for intensivists .', 'Pressure ulcer is a serious and persistent problem for patients throughout the Western world .', 'Even in the present , pressure ulcers still represent a severe health problem , particularly in Intensive Care Units ( ICU ) .', 'Pressure ulcers are serious and common health concern affecting about 1.5 - 3 million adults and is a serious health concern for elders .', 'Pressure ulcers ( PUs ) are a serious health care problem for nursing home residents and a key quality metric for regulators .', 'Pressure ulcers ( PUs ) are considered a serious problem in nursing care and require preventive measures .', 'Recurrent pressures sores are a serious problem that often cause chronically ill patients to be hospitalized .']


Cluster  2120
['One hundred patients undergoing elective surgery were recruited.', 'In total, 164 patients with a median age of 61 (range 26-86) years were considered to be at low risk (143, 87·2 per cent) or high risk (21, 12·8 per cent) of surgical difficulty.', 'We included patients aged ≥ 60 years undergoing non-cardiac surgery planned for longer than 60 min.', 'Among the 1900 included patients, 1497 (79 %) met the ACOSOG Z-0011 criteria before surgery.', 'Postoperative morbidity was 7.', 'Ninety-six patients for the laparoscopic group and 52 for the open group were eligible for data analysis.', 'Fifteen patients scheduled for upper extremity surgery, aged 20 to 70 years, with ASA physical status I or II were included.', '- In the preoperative group, 80.', 'We recorded 83 attempts in 74 patients, with a median age of 44\xa0years and a median body mass index of 27\xa0kg/m<sup>2</sup>.', 'We enrolled 92 patients older than 18 years undergoing elective OPCAB-surgery.', 'One hundred and forty patients were included and allocated into 2 groups that were comparable in demographic characteristics, surgical intervention type and anesthesia duration.', 'A total of 127 participants undergoing laparoscopic thoracic or abdominal surgery were recruited between January and November 2015.', 'Of 10,301 patients in the surgical cohort, 804 (7.']


Cluster  2330
['Oral 24% sucrose or placebo solution was administered 2 minutes prior to PIV catheter insertion.', 'At least 48\xa0h before undergoing surgery for PDAC, 12 patients were injected intravenously with 5, 7.', 'Intravenous pre-injection of 7.', 'Patients with clinical indications for VCE were randomized to (1) clear fluids only the evening before VCE, (2) 2 sachets of sodium picosulfate plus magnesium sulfate (P/MC) the evening before, or (3) 2 L of polyethylene glycol (PEG) the evening before.', 'Implantation of the Tenckhoff catheter and installation of PD fluids induce inflammation, which in the first days resembles an acute inflammatory response.']


Cluster  1107
['Xanthomonas maltophilia infection is recognized as a serious problem in association with immunosuppressive and invasive therapies , and with the use of broad-spectrum antibiotics .', 'Helminth neuroinfections represent a serious health problem , but host immune mechanisms in the nervous tissue often remain undiscovered .', 'Human-infecting microbial pathogens all face a serious problem of elimination by the host immune response .', 'As resistance to the clinically used antiinfectives is a serious healthcare problem worldwide , inhibition of parasite CAs may constitute an alternative approach for obtaining such agents with novel mechanisms of action .', 'Moraxella osloensis rarely causes infection in humans, and most of the reported cases are not fatal', 'The emergence of multidrug-resistant Capnocytophaga species is a serious concern for effective antimicrobial therapy .', 'We have discussed the hepatic Lm infection in adult compromised hosts , which conventionally has not been considered a serious problem .', 'Loa loa infections have emerged as a serious public health problem in patients co-infected with Onchocerca volvulus or Wuchereria bancrofti because of severe adverse neurological reactions after treatment with ivermectin .']


Cluster  1460
['Respiratory disorders during sleep are a serious medical , economic and social problem .', 'Snoring : an annoyance or a serious health problem ( obstructive sleep apnea ) ?', 'Obstructive sleep apnoea ( OSA ) is a serious worldwide health problem .', 'Sleep disturbance is a serious health concern among asthma patients .', 'Obstructive sleep apnea syndrome (OSAS) is a frequent sleep-related breathing disorder being associated with cardiovascular, metabolic and neurobehavioral consequences.', 'Obstructive sleep apnea-hypopnea syndrome ( OSAHS ) is a serious social health problem with significant implications on quality of life .', 'Obstructive sleep apnea is increasingly being recognized as a serious public health problem , and is characterized by repetitive , complete or partial closure of the upper airway during sleep , resulting in sleep fragmentation and oxygen desaturation .', "By the way , doctor . My wife says I snore a lot . I do n't think I have sleep apnea , but I 'm not sure . Is there anything I can do for a serious snoring problem ?", 'Improving nasal patency by decongestant could improve sleep quality, AHI, and oxygen saturation level during sleep.', 'Sleep-apnea syndrome is a serious problem in respiratory care .', 'Snoring and apneas while sleeping are symptoms that should lead to the suspicion of the presence of OSAS.']


Cluster  72
['Hepatitis delta ( HDV ) virus still poses a serious health problem worldwide .', 'Viral hepatitis B , C and delta still remain a serious problem worldwide .', 'Mouse hepatitis virus ( MHV ) infection in laboratory mouse populations is a serious problem , because the MHV infections are known to interfere with research results .', 'Viral hepatitis is a serious health problem that deserves special attention .', 'The presence of HAV in water samples constitutes a serious public health problem .', 'Viral hepatitis represents a serious public health problem in the world especially in the Maghreb where the prevalence of the 5 viruses A , B , C , D , and E remains high and varies from one Maghreb country to another , there is few published studies on these infections in our Maghreb countries .', 'The viral hepatitis is a serious public health problem worldwide .', 'Hepatitis B virus and Hepatitis C virus infections are among the most common viral infections globally and maintain their position as a serious public health problem .', 'Hepatitis C virus ( HCV ) infection is a serious health problem in Georgia .', 'Hendra virus ( HeV ) continues to pose a serious public health concern as spillover events occur sporadically .', '[ Viral hepatitis ... a serious public health problem ] .', 'Viral hepatitis is a serious public health problem affecting billions of people globally with maternal-fetal transmission on the rise .', 'Hepatitis delta virus ( HDV ) infection is a serious health problem worldwide .', 'Rabbit hemorrhagic disease virus ( RHDV ) is the etiological agent of a lethal and contagious disease of rabbits that remains as a serious problem worldwide .', 'Viral hepatitis is a serious health problem all over the world .', 'Viral hepatitis is a serious public health problem .', 'Hepatitis C virus ( HCV ) infections caused by occupational percutaneous injuries are a serious problem for healthcare workers and there has been a gradual increase in the number of HCV infections .', 'Chronic forms of viral B , C and D hepatitis and fulminant hepatitis represent a serious healthcare problem .', 'Viral hepatitis is a serious medical and economic problem .', 'Our study clearly indicates a high prevalence of those viruses , particularly of enterically transmitted HAV and HEV in Bangladesh , which appeared to be a serious health problem in this developing country .', 'Worldwide , viral hepatitis chronic infections are a serious health problem and a very interesting topic for both clinicians and researchers .', 'Hepatitis is a serious public health problem with increasing cases and property damage in Heng County .']


Cluster  1813
['The main limitation is that E1 and E2 regularization can not let the model give weight to conjunctions that have not been observed at training', 'In the experiments reported in this paper , we split the corpus into chunks of a size of around 4 megabytes . E1 and E2 regularization can not let the model give weight to conjunctions that have not been observed at training', 'We tried several frequently applied or newly proposed regularization strategies , including penalizing weights -LRB- embeddings excluded -RRB- , penalizing embeddings , reembedding words , and dropout . the features considered are local to the alignment links joining pairs of words', 'In the experiments reported in this paper , we split the corpus into chunks of a size of around 4 megabytes . E1 and E2 regularization can not let the model give weight to conjunctions that have not been observed at training', 'In the experiments reported in this paper , we split the corpus into chunks of a size of around 4 megabytes . E1 and E2 regularization can not let the model give weight to conjunctions that have not been observed at training']


Cluster  1500
['Significantly higher concentration of neutrophil elastase, IL-1, IL-6 and C-reactive protein was detected postoperatively in the 30% FiO2 group patients in comparison with the 80% FiO2 group (P<0.', 'IL-6 levels were lower in the ERAS group on 1, 3, and 5 days postoperatively (P<0.', 'Salvaged autologous blood leukocyte filtration can improve ventilation, promote gas exchange and oxygenation, and inhibit lung inflammatory and oxidative stress reactions in elderly patients undergoing lumbar spinal surgery.', 'This study demonstrated that high-concentration (80%) supplemental perioperative oxygen can lead to a reduction in postoperative inflammatory response and avoid postoperative immunosuppression.', 'This study assessed effect of administration of high-concentration supplemental perioperative oxygen on systemic inflammatory and immune response in patients undergoing elective laparoscopic cholecystectomy.', 'Retention of the supracrestal connective fibres appears to reduce the postsurgical intensity of the host-mediated inflammatory response.', 'Postsurgery, a higher number of inflammatory cells and stronger expression of proinflammatory cytokines were observed in the epithelium and connective tissue of ORS gingival samples compared with FibReORS gingival samples (p < 0.']


Cluster  1406
['Adverse drug events ( ADEs ) are a serious health problem and are the leading adverse event experienced by hospitalized patients .', '\xa0 in clinical settings , but its adverse drug reactions ( ADRs ) can be a serious public health concern .', 'Attrition due to safety reasons remains a serious problem for the pharmaceutical industry .', 'Pharmacovigilance education is essential since adverse drug reactions ( ADRs ) are a serious health problem and contribute to unnecessary patient burden and hospital admissions .', 'Under-reporting is a major drawback of a voluntary adverse drug reaction reporting system in pharmacovigilance .', 'Drug safety is a severe clinical pharmacology and toxicology problem that has caused immense medical and social burdens every year .', 'Adverse events pose a serious problem for quality of healthcare .', 'Adverse drug effects are a serious problem in hospital patient care [ 1 ] .', 'The chemical contamination during the preparation of cytotoxics remains a serious problem in hospital pharmacies and the operators could contribute to this risk during their manipulations .', 'Adverse drug reactions therefore represent a serious medical and financial problem .', 'Adverse drug reactions ( ADRs ) are a severe problem .', 'Adverse events are a serious concern .']


Cluster  791
['TD was associated with academic difficulties, namely, LD in conjunction with ADHD but not GR.', 'Anamnesis, physical examination, and simple laboratory data could provide some important clues in assessing MDD.', 'These results suggest that GDM can contribute to subtle differences in child neurophysiology, and possibly cortisol secretion, persisting into early adolescence.', 'GDM-exposed children had reduced cortical excitability (p\u202f=\u202f.', 'Scores on both instruments state that DCD likely represents a serious problem for children , and add to the body of evidence supporting the notion that children with DCD have lower overall HRQOL .', 'Clinical inertia in treating patients with T2DM is a serious problem .', 'An observational study was conducted to calculate the correlation of TMD, as assessed with DC/TMD criteria, with sociodemographic, psychological and clinical features on 59 voluntary subjects with TMD (n\xa0=\xa045) and without TMD (n\xa0=\xa014).', 'We clearly identified that the etiologic mechanisms of T1DM and T2DM are not mutually exclusive, and we detailed why FCP levels are not critical for the classification system of DM in children.', 'Four specific dysplastic types possess higher diagnostic efficacy for the diagnosis of MDS.']


Cluster  1305
['White tail disease ( WTD ) , caused by Macrobrachium rosenbergii nodavirus ( MrNV ) , is a serious problem in farm cultivation and is responsible for up to 100 % mortality in the post larvae stage .', 'White tail disease ( WTD ) is a serious problem in Macrobrachium rosenbergii hatcheries and nursery ponds in Asia .', 'White tail disease ( WTD ) was found to be a serious problem in hatcheries and nursery ponds of Macrobrachium rosenbergii in India .', 'White tail disease ( WTD ) caused by Macrobrachium rosenbergii nodavirus ( MrNV ) and extra small virus ( XSV ) is a serious problem in prawn hatcheries .']


Cluster  1400
['Tinnitus as a symptom remains a serious multidisciplinary problem .', 'The results of this pilot study suggest that providing tailored auditory stimulation with frequency-specific gain and compression may alleviate tinnitus in a clinical population.', 'Tinnitus is defined as a sound in the ear(s ) and/or head without external origin and is a serious health concern for millions worldwide .', 'The study will test the efficacy of group CBTi as a treatment for tinnitus-related insomnia in a single-centre randomised controlled trial.', 'Tinnitus is an apparent sound, perceived in the ear with no stimulus.', 'In total, 46 patients referred to our department with bilateral subjective tinnitus with TMDs were selected for this study.', 'The Cognitive Behavioral Model of Tinnitus Distress proposes that tinnitus becomes and is maintained as a distressing problem due to a process of interaction between negative thoughts , negative emotions , attention and monitoring , safety behavior , and beliefs .', 'Both the Nd:YAG and 810\u2009nm diode lasers were effective for the treatment of subjective tinnitus related to TMDs.', 'Changes in Tinnitus Handicap Inventory and Numeric Rating Scales were measured in 20 patients after 3 and 6 months following the fitting of ear-level multi-colour sound generators.', 'Pulsatile tinnitus can often present a serious diagnostic problem .']


Cluster  1587
['Chronic pain with mood disorder , resulting from a peripheral nerve injury , is a serious clinical problem affecting the quality of life .', 'Treatment of neuropathic pain ( NP ) is a serious medical problem .', 'SUMMARY \xa0 Persistent neuropathic pain after spinal cord injury ( SCI ) is a serious problem that significantly affects general health and wellbeing over and above what is caused by other medical consequences after SCI .', 'Neuropathic pain is a severe health problem for which there is a lack of effective therapy .', 'The outcome of peripheral nerve injury is often impaired by neuropathic pain , which is resistant to most analgesics and presents a serious clinical problem .', 'Neuroma is usually accompanied by neuropathic pain , which is usually resistant to most analgesics and presents a serious clinical problem .', 'Neuropathic pain , resulting from nervous system injury or dysfunction , can be a serious medical problem and especially difficult to treat .', 'Neuropathic pain concurrent with mood disorder from peripheral nerve injury is a serious clinical problem that significantly affects quality of life .', 'Neuropathic pain is a serious public health problem and has a strong affective-motivational component that makes it difficult to treat .', 'Neuropathic pain , resulting from somatosensory nervous system dysfunction , remains a serious public health problem worldwide .', 'Chronic neuropathic pain following surgery represents a serious worldwide health problem leading to life-long treatment and the possibility of significant disability .']


Cluster  173
['Of 127 eligible patients, 126 were randomized; 124 patients (61 standard diet, 63 supplemented diet) were analysed for safety and 123 (60 standard diet, 63 supplemented diet) for efficacy.', 'Morbidly obese patients selected for LRYGB were included in a prospective study.', 'The diet intervention resulted in decreased pain and improvement in quality of life.', 'The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.', 'To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values.', 'Obese participants ( n = 34) took part in 12 months of ADF and were grouped into a high (≥5%) or low-weight-loss (<5%) group post-treatment.', 'Elderly patients lost significantly more weight with LRYGB compared with SG.', 'A randomised, double-blind, placebo-controlled clinical trial was performed enrolling 56 overweight and obese subjects (body mass index, BMI, 25-35\u2009kg\u2009m<sup>-2</sup> ) who were not following any specific diet, and were given placebo or BGCC (3\u2009g d<sup>-1</sup> ) for 12 weeks.', 'The greater weight loss experienced in the patients undergoing PENS T6 is associated with appetite reduction and greater diet compliance.', 'This is secondary analysis from a single-blinded randomized controlled trial, including healthy women (aged 18-65) with a BMI (kg/m<sup>2</sup>) ≥25.', 'The current LIP was effective in losing body weight, improving depression and QoL of MetS populations in three-month observation.', 'Prospectively validated preoperative models predict, in individual patients, weight and obesity co-morbidities 2 years in advance for RYGB, LRYGB, LAGB, SG, and BPD/DS.', 'This is a randomized trial, according to CONSORT standards, with obese adults aged 18-40 years.', 'This study is the first to combine previously successful single nutritional interventions into a multimodal intervention whose aim is to obtain an effect on patient-related outcomes.', 'Thus, individuals who achieve clinically significant weight loss with ADF demonstrate improved satiety, increased protein intake, and better adherence to fast-day calorie goals.']


Cluster  949
['One problem with cell phone samples is that persons who move or who purchase cell phones in locations not close to their residence , may not be eligible for surveys with geographic parameters .', 'A limitation to the use of matching with replacement is that variance estimation must account for both the matched nature of the sample and for some control subjects being included in multiple matched sets .', 'Because the program is statewide , finding a suitable control group to evaluate it was a serious problem .', 'A problem with previous research , however , is that groups have not been matched for drawing ability .', 'A potential problem with their approach is that older records would be expected to include a disproportionate numbers of recidivists .', 'A possible drawback of such an approach , of early identification of high risk groups , is the uncertainty it arouses , sometimes for a long duration , with the accompanying apprehension and stress parents have to endure .', 'The problem , however , with a re-emphasis on personality variables is that any one of scores of dimensions can be chosen for study .', 'However , this variation is not necessarily indicative of a serious maldistribution problem since there are regional differences in need and supply .', 'The identification of those individuals at high risk is still in its infancy and presents a troubling dilemma .']


Cluster  1657
['The majority of participants 143 ( 95 % ) recognised delirium as a serious problem and 93 % considered delirium to be an under-diagnosed syndrome that requires active medical intervention .', 'Delirium is a serious and prevalent problem in intensive care units ( ICU ) .', 'Awareness of the clinical importance of delirium in adults is growing as emerging research demonstrates that delirium represents a serious medical problem with significant sequelae .', 'As delirium in intensive care unit ( ICU ) patients is a serious problem that can result in increased mortality and morbidity , routine delirium assessment of all ICU patients is recommended .', 'Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist.', 'Delirium is a serious and common problem in severely medically ill patients of all ages .', 'Delirium is a serious problem when caring for a patient with cancer in the hospital .', 'Delirium is a life-threatening , frequently reversible condition that is often a sign of an underlying health problem .', 'Delirium is a serious problem with important consequences and can be prevented or improved using the information that we have learned in the last decade .', 'Delirium is a serious medical problem and recognized as a common syndrome in critically ill children .', 'This substudy was part of a larger multicenter, randomized, double blind, placebo-controlled clinical trial among hospitalized patients aged 70 years and older who had an increased risk of in-hospital delirium.', 'Delirium in the intensive care unit is a serious problem that has recently attracted much attention .', 'Although delirium is considered as a serious problem by a majority of the surveyed ICU professionals , it is still under-recognized in routine critical care practice .', 'The results indicate that improving delirium recognition and treatment through interprofessional education can reduce falls and length of stay.', 'Delirium is a serious and common problem in people over 60 \xa0 years of age who are admitted to hospitals .', 'The high incidence of delirium in surgical units is a serious quality concern , given its impact on morbidity and mortality .']


Cluster  61
['The high associated radiation doses are a major drawback of brain perfusion CT .', 'We conducted a retrospective longitudinal study of adult subjects who underwent multiple facial computed tomographic (CT) scans timed at least 8\xa0years apart.', 'Transverse image truncation can be a serious problem for human imaging using cone-beam transmission CT ( CB-CT ) implemented on a conventional rotating gamma camera .', 'High radiation doses remain a drawback of current triple-rule-out computed tomography ( CT ) protocols .', 'Excessive radiation exposure in pediatric computed tomography ( CT ) scanning has become a serious problem , and it is difficult to select scan parameters for the scanning of small patients such as children .', 'The current study aimed to analyze the minimum RABQ to prevent the extension of periodontal pathology from reaching maxillary sinus using cone-beam computed tomography (CBCT).', 'Magnetic resonance imaging has been recognized for years as the safest and most precise imaging method, particularly for children.', 'Simultaneous reductions in iodine dosage and radiation dose by one-third are feasible for CT of the chest.', 'The main benefit of CT-guided injections is the safe , fast and precise needle placement , but the radiation exposure remains a serious concern .', 'This study was based on retrospective evaluation of cone beam computed tomography (CBCT) scans.']


Cluster  555
['Many researchers have done a lot of research and achieved remarkable results , but TB is still a severe problem for human beings .', 'Despite decreasing numbers of cases in the United States since 1992 , TB remains a serious public health problem among certain patient populations and is highly prevalent in many urban areas .', 'Although TBE is a serious problem in Latvia , the knowledge concerning TBE virus ( TBEV ) strains circulating in the country is most limited .', 'Such high PTB incidence , particularly in the age group 20 - 29 , clearly indicates that TB in Korea remains a serious health problem .', 'To compare six versus 12 months of anti TB therapy in patients with biopsy proven spinal TB.', 'Tuberculous ( TB ) meningitis in children under 5 years of age is a serious health problem in Argentina , with a rate of 0.39/100000 inhabitants , for 2003 - 2004 .', 'Patients hospitalized with TB have on average four different dermatoses, but xerosis remains the leading dermatological finding, irrespective of HIV status or TB drug sensitivity.', 'TB still represents a serious public health problem .', 'South Korea regards tuberculosis ( TB ) incidence in congregate settings as a serious problem .', 'A total of 9867 new cases of TB were identified.', 'TBE is a serious problem in Latvia with up to a 1,000 patients confirmed serologically annually 1994 - 1995 .', 'Unemployment among TB patients is a serious problem .', 'In Korea , TB continues to be a serious public health problem .', 'The increasing number of sputum smear- and culture-negative TB patients is a serious concern because misdiagnosis and delayed treatment can lead to increased morbidity and mortality and increased infectious transmission .', 'This observational, cross-sectional, epidemiological study was conducted using data provided by SINAN-Net on subjects diagnosed with TB between 2008 and 2012 in Paraná, Brazil.', 'TB-DM comorbidity is expected to pose a serious future health problem due to the alarming rise in global DM incidence .', 'The detection of the contacts of index cases constitutes an epidemiological and public health strategy for the surveillance and control of TB.', 'We conclude that TB among farm workers represents a serious public health problem with previously unrecognized risk factors .', 'Tuberculosis ( TB ) is a serious public health problem ; however , the cutaneous form remains rare .', 'The low number of cases of tb diagnosed before death represents a serious problem .', 'Tuberculosis is a serious health problem in Brazil so that the knowledge on the aspects of cutaneous tuberculosis is medically important .', 'The high prevalence of diabetes mellitus ( DM ) among multidrug resistant tuberculosis ( MDR-TB ) patients is a serious cause for concern .']


Cluster  744
['Addition of dexmedetomidine to propofol-remifentanil TIVA resulted in a significant decrease in cerebral oxygenation (P<sub>br</sub>O<sub>2</sub>) measurements in piglets with lowered blood pressure.', 'Patients undergoing open radical gastrectomy under total intravenous anesthesia were randomly allocated to the control group (group Con) and the dexmedetomidine group (group Dex).', 'Intraoperative dexmedetomidine infusion at rates of 0.', 'Incisional infiltration of ropivacaine combining with dexmedetomidine could significantly reduce postoperative pain and the amount of pethidine requirement.', 'Among the different adjuvants, dexamethasone is one of the most accepted to prolong the effect of local anesthetics.', 'Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine.', 'There was no significant difference between the dexamethasone and saline groups with respect to time to first analgesic requirement, intraoperative fentanyl requirements, time to emergence from general anesthesia, and incidence of postoperative nausea and vomiting.', 'Compared with remifentanil, the use of dexmedetomidine was associated with reduced postoperative MAP (88±12 vs.', 'Sixty patients undergoing laparoscopic colonic resection were enrolled and allocated randomly to treatment with dexmedetomidine (group D) or morphine (group M).', 'The consented 90 patients were randomized into 2 groups: one group received 8 mg (2 mL) of dexamethasone, whereas the other received 2 mL of normal saline along with the local anesthetics in the scalp nerve block administered soon after induction of general anesthesia.', 'This study concluded that remifentanil and dexmedetomidine exhibited similar efficacy and safety during general anesthesia for cesarean delivery.']


Cluster  367
['Most studies have been carried out on individuals with a serious drinking problem , in most cases alcoholics .', 'Substance abuse in the elderly is a serious problem that is often overlooked .', 'Participants ( N = 25 ) with a severe mental illness who were receiving mental health outpatient treatment at a state psychiatric hospital were interviewed regarding the resolution of their alcohol problem .', 'We wished to determine if offspring of families exhibiting a positive history of alcoholism ( FH+ ) reported a serious alcohol or drug problem ( including seeking treatment ) at a higher rate than those without such backgrounds ( FH- ) .', 'Childhood abuse is a serious problem that has been linked to harmful alcohol and drug use in non-offender samples .', 'To examine the prevalence of heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) in patients with inflammatory skin disease.', 'This was a multi-center, retrospective, observational study of patients presenting to the ED for ethanol intoxication.', 'At the HIV outpatient department of the University Hospital in Basel , nurses are assessing patients and it is evident that alcohol intake is a serious health problem for some of them .', "medication adherence in patients with alcohol-related liver disease is likely to be improved by an intervention that strives to improve the patient's understanding of their illness condition and their perception of their illness symptoms.", 'The aim of this prospective study was to estimate gender differences in anxiety, depression, and alcohol use severity among patients with alcohol use disorder (AUD) before and after detoxification program and within 12\xa0months after discharge.', 'Alcoholism in the elderly . A serious but solvable problem .', 'Variables such as diagnostic testing, treatments, and hour of arrival may influence ED LOS in patients with acute ethanol intoxication.', 'Injury is a serious problem for a substantial proportion of patients who undergo detoxification , particularly those with alcohol dependence .', 'Possibly because staff do not identify alcohol use as a serious problem for psychiatric inpatients , it is not considered in treatment planning .', 'In conclusion , older adolescents who present for treatment of an assault-related injury or acute alcohol intoxication , who are alcohol-positive in the ED , and who report getting intoxicated once a month or more are likely to have a severe drinking problem .', 'This is the first study to investigate alcohol-related injuries occurring at home.', 'This study aimed to establish the scale of alcohol-related injuries originating in the home.', 'Severe alcohol use does not seem to represent a serious problem in renal transplant patients .']


Cluster  880
['Despite improved pharmacological control of SAT in many patients , the potential for stent occlusion remains a life-threatening problem for those with more complex lesions .', 'Single-stent implantation without FKBT may be a sufficient treatment strategy for bifurcation ISR lesions.', 'In this single-centre observational study, patients who were diagnosed with at least 60% angiographic stenosis unilaterally or bilaterally between January 1996 and October 2008 and who were followed-up until February 2011 were retrospectively analysed.', 'The WAVE study shows that iFR yields similar diagnostic accuracy to FFR in functional evaluation of non-IRA stenosis in patients with STEMI and multivessel CAD, with the advantage of being adenosine free.', 'To investigate whether indwelling time of double-J stent can predict which treatment modality is required for removal of the stent from the body.', 'The indication for interposition graft placement was recurrent stenosis with inability to perform endarterectomy in nine operations , a severe kink or technical problem during endarterectomy in nine , aneurysmal changes of the artery in six , and thrombosis of the endarterectomy site segment with stroke in two .', 'As the population with SFA stenting continues to increase , occurrence of ISR has become a serious problem .', 'In-stent stenosis is a serious problem , occurring more frequently than earlier reports suggest and potentially resulting in late complications .', 'Patients were classified according to their duration of the stent indwelling time.', 'In total, 52 patients in the 1-week stent group and 51 patients in the 4-week stent group were analyzed.', 'Failure to deploy stents is a serious and relatively common problem that is associated with significant morbidity and mortality rates .', 'To evaluate the use of TFESI as an alternative to surgery in patients with symptomatic stenosis.', 'Despite improved pharmacological control of SAT in many patients , the potential for stent occlusion remains a life-threatening problem for those with more complex lesions .', 'Nevertheless , ISR remains a serious concern as late stent complications .']


Cluster  982
['77.', 'Only 18.', 'Seventeen (42.', '72.', '32.', 'In 66.']


Cluster  2116
['Knee swelling was reduced in both groups after 14 days, but was slightly more in the intervention group.', 'Age, subcutaneous tophus count and tender joint count were independently associated with XR damage score at the baseline visit.', 'After a single treatment, swelling was more severe in younger patients (p<0.', 'Increases in the American College of Rheumatology (ACR) response rates (ACR20, ACR50, and ACR70) observed during the first 12 weeks were maintained during the extension period, accompanied by improvements in ACR core components.', 'Persistent joint inflammation and reactivity remain a vexing issue , and long-term durability is of significant concern .', 'The study involved 32 healthy male subjects who were randomly divided into 2 groups: 16 men exposed to WBC procedures with subsequent kinesiotherapy (WBC group) and 16 men exposed only to kinesiotherapy procedures (KT group).']


Cluster  1503
['Being highly self-efficacious is a key factor in successful chronic disease self-management.', 'Competence and self-efficacy showed no significant between-group differences in mean improvements, but significant improvements in both groups were detected over the 5\xa0weeks.', 'The aim of this study was to investigate the effectiveness of a brief self-regulatory intervention (targeting illness perceptions and coping) at improving HNC patient health-related quality of life (HRQL).', 'In both trials, a statistically significantly greater improvement was observed for both the knowledge and self-efficacy scores in intervention vs.', 'Compared to the control group, patients who received the intervention had increased treatment control perceptions at 3\xa0months (p\xa0=\xa0.', 'The findings of this study indicate that self-help guidance may be beneficial for patients with CFS who are awaiting CBT treatment or those who are unable to access specialist treatment in their local area.', 'Fear avoidance and self-efficacy were important causal mediators of the cognitive behavioral treatment effect.', 'This analogue study supports the rationale of cognitive therapy and provides a general therapeutic model in which experiential interventions that produce success have a significant immediate effect on a behavioral task, mediated by changes in beliefs and mood.', 'After the 6-month intervention, the self-management ability of the intervention group was significantly different from that of the control group (P<0.']


Cluster  43
['Early bowel obstruction is not a rare complication of gastrectomy, and it may require re-operation in some cases', 'ERAS is safe and enhances postoperative recovery after TLDG in gastric cancer.', 'To predict preoperatively and validate prospectively the weight and co-morbidity resolution in individual patients after open Roux-en-Y gastric bypass (RYGB) and laparoscopic Roux-en-Y gastric bypass (LRYGB), laparoscopic adjustable gastric band (LAGB), sleeve gastrectomy (SG), and biliopancreatic diversion/duodenal switch (BPD/DS).', 'This study demonstrates the feasibility and safety of ERAS protocol in advanced gastric cancer patients undergoing laparoscopic radical gastrectomy and was associated with shorter duration of hospital stay.', 'We analyzed 113 cases (73 distal gastrectomy, 40 total gastrectomy).', 'Postoperative body compositions and nutritional status were not affected by surgical approaches during the first 12 months after surgery in patients who underwent distal gastrectomy for stage I GC.', 'ERAS combined with laparoscopic gastrectomy was observed in our study.', 'In selected patients, SP surgery presented less postoperative pain in sleeve gastrectomy compared with the conventional laparoscopic approach with similar surgical results.', 'NOSE laparoscopic subtotal gastrectomy is feasible and safe, with similar oncologic results as LAG, but decreased morbidity and hospital stay.', 'Twenty-two participants were included (17 gastric bypass; 4 sleeve gastrectomy; 1 intragastric balloon).', 'This study showed ONS after total gastrectomy to significantly diminish postoperative weight loss.', 'Total gastrectomy for gastric cancer is associated with excessive weight loss and decreased calorie intake.', 'Patients with gastric cancer indicated for TLDG were randomly assigned to either the ERAS group or the conventional group.', 'Compare conventional multiport laparoscopy (LAP) with an SP approach for the treatment of morbid obesity using sleeve gastrectomy in terms of postoperative pain using a visual analog scale (VAS) 0-100, surgical outcome, weight loss, and aesthetical satisfaction at 6 months after surgery.', 'PREFOG study will show if home-based trimodal prehabilitation is effective to reduce postoperative morbidity after gastrectomy for gastric cancer.', 'To evaluate the long-term effects of laparoscopic Roux-en-Y Gastric Bypass (LRYGB) on gastroesophageal function.', 'Immunonutrition based on an eicosapentaenoic acid-enriched oral diet did not reduce bodyweight loss after total gastrectomy for gastric cancer compared with a standard diet.', 'PREFOG is a multi-center, open-label randomized control trial comparing 90-days postoperative morbidity rate after gastrectomy for gastric cancer between patients with or without prehabilitation.']


Cluster  474
['VAS, ODI, kyphosis angle and vertebral height of 44 patients were evaluated preoperatively, 3 and 12 months postoperatively.', 'Significant reduction in the mean movement of subcutaneous tissue during lumbar flexion before and after taping was found.', 'rPMS can constitute an effective treatment for subjects with lumbar radiculopathy and its association with a complex physical rehabilitation program could improve the outcome in these patients.', 'Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group ( p\u2009<\u20090.', 'Both treatments improved vertebral height and kyphosis angle.', 'Compared with preoperative values, in the IM group, forward flexion improved from 106° to 141° at 1 year postoperatively, external rotation improved from 21° to 65°, and internal rotation improved by 2 spinal levels (P\u2009<\u2009.', 'The ODI-I proved to be responsive in detecting changes after conservative treatment in subjects with lumbar SPL.', 'KT reduced subcutaneous inter-tissue movement and paracutaneous translation in the superficial thoracolumbar fascia during lumbar flexion, and the relationship of such difference to symptomatic change merits exploration.', 'Both groups achieved comparable outcomes, but the course of VAS and kyphosis angle differed.']


Cluster  550
['Conservative treatment of PM initially with enforced training of the vastus medialis obliquus (VMO) has been widely applied.', 'Mean movements of all 3 clips in bilateral nonfixation (NF) group were 0.', 'The aim of this study is to propose a surgical approach based on upper limb functional level and manipulation strategy and establish whether multilevel surgery can improve segmental alignment, performance and capacity, that ICF defines as activities and participation qualifiers.', 'Thirty healthy adults were randomly allocated to one of two intervention groups: active joint motion and no joint motion.', 'Comparing with the Instrumental Group, the Manual Group showed statistically significant improvements on flexion-rotation test (p< 0.', 'The extension and flexion peak torque at 60°/s showed no significant interaction between the time and intervention or between the interventions.', 'For left knee ROM, the active joint motion group demonstrated the greatest immediate increase in passive ROM (8°, p\u202f<\u202f.', 'These finding suggest that foam rolling can immediately reduce PPT in the ipsilateral agonist, antagonist, and contralateral muscle groups among men and women.', 'Foam rolling is a better option than Neurodynamic therapy for reduction of intensity of DOMS.', 'The aim of this study was to investigate whether active repetitive training of the mandible into an anterior position would result in a shift of the habitual mandibular position (HMP).', 'A short session of foam rolling with active joint motion appears to have a greater effect on passive joint ROM and PPT than rolling without motion.', 'The HMP in the training group showed a statistically significant anterior shift of 1.', 'A similar evolution was observed in patients treated with rigid immobilization with or without PRP after 24 weeks.']


Cluster  2104
['We compute edit-probability between the graphemes of si and ti . feature sparseness', 'We compute edit-probability between the graphemes of si and ti . feature sparseness', 'We compute edit-probability between the graphemes of si and ti . feature sparseness']


Cluster  513
['Immediately following injury , burn shock represents a life-threatening problem .', 'Concomitant smoke inhalation trauma in burn patients is a serious medical problem .', 'Although rare , head burns involving the calvarium are a serious complication of burns and electrical injury , and present therapeutic challenges to the surgical burn care team .', 'Thermal injury ( TI ) with septic complications continues to be a serious clinical problem .', 'Smoke inhalation injury is a serious medical problem that increases morbidity and mortality after severe burns .', 'Accidental hypothermia represents a serious problem in multiple trauma patients due to its frequency and negative pathophysiological effects .', 'Burns of the head and neck with or without respiratory tract injury remain a serious and complex problem .', 'Smoke inhalation in burn patients is a serious medical problem around the world .', 'Burns are a common condition presenting to the emergency department; the majority are thermal burns', 'A serious problem in emergency medicine is the correct evaluation of skin burn depth to make the appropriate choice of treatment .', 'The treatment of burns of various depth and location which are combined with thermoinhalation affections of the respiratory organs is a serious problem during the entire course of burn disease .']


Cluster  1825
['Dengue is a serious public health problem in Colombia ; it is prevalent in 90 % of the municipalities in Quindío .', 'Dengue is emerging as a serious public health problem in Tamil Nadu .', 'Dengue infection is emerging as a serious public health problem in Tamil Nadu .', 'Dengue Haemorrhagic Fever ( DHF ) is a serious and often fatal paediatric problem in Myanmar .', 'Dengue represents a serious public health problem worldwide and is caused by infection with dengue virus ( DENV ) .', 'Dengue is a serious problem around the globe , with 3.9 billion people at risk of the disease .', 'Dengue fever is a serious concern for Japanese people staying in Southeast Asia .', 'Dengue fever is a serious public health problem and is emerging as a continuous threat in Guangdong Province .', 'Dengue fever is a severe public health problem for several countries .', 'Dengue viral disease has been reported as an Aedes aegypti mosquito-borne human disease and causing a severe global public health concern .', 'Dengue virus ( DENV ) is a serious global health problem .', 'Dengue is a serious public health problem worldwide .', 'Dengue has become a serious public health problem in southern China particularly with a record-breaking outbreak in 2014 .', 'As the primary vector for dengue , Ae . aegypti now occurs in over 20 countries and is a serious concern with reports of increasing insecticide resistance .', 'Dengue is a serious global health problem endemic in Brazil .', 'Dengue is the most important infectious disease in the world and is a severe public health problem .', 'Dengue disease is caused by any 1 of 4 dengue virus serotypes and is a serious public health concern in Latin America .', 'Dengue is a serious public health problem in Metro Manila , Philippines .', 'Dengue virus infections are a serious public health problem in tropical and subtropical areas of the world .', 'Dengue virus ( DENV ) infection , which causes dengue fever , dengue hemorrhagic fever , and dengue shock syndrome , is a severe global health problem in tropical and subtropical areas .', 'Dengue is a serious public health problem worldwide , with cases reported annually in tropical and subtropical regions .', 'At the present time , dengue is one of the most important arboviruses affecting man , becoming a serious global public health problem , especially in subtropical and tropical countries , where environmental conditions favor the development and proliferation of the mosquito Aedes aegypti .', 'Dengue endemic is a serious healthcare concern in tropical and subtropical countries .', 'Dengue fever ( DF ) is a serious public health problem in many parts of the world , and , in the absence of a vaccine , disease surveillance and mosquito vector eradication are important in controlling the spread of the disease .', 'Dengue infection poses a serious public health problem in most tropical and subtropical areas .', 'Dengue hemorrhagic fever ( DHF ) , a disease transmitted by Aedes mosquitos , remains a serious public health problem in Thailand .', 'Dengue fever has been a serious public health problem in Brazil for decades , with recurrent epidemic outbreaks occurring during summers .', 'Dengue virus infection is a serious public health problem in endemic areas of the world where 2.5 billion people live .', 'Dengue is a serious public health problem in numerous countries .', 'The current triple epidemic caused by dengue , zika and chikungunya constitutes a serious health problem in Brazil .', 'Dengue is a serious infectious disease and a growing public health problem in many tropical and sub-tropical countries .', 'Dengue is an acute emerging infectious disease transmitted by Aedes mosquitoes and has become a serious global public health problem .', 'Determine the epidemiological behavior and the geographic distribution of dengue fever cases treated in the San Rafael Hospital in the municipality of the El Espinal, from 2010 to 2014.', 'The escalating dengue situation in Bangladesh has been emerging as a serious public health problem in terms of morbidity and mortality .', 'Dengue fever and dengue haemorrhagic fever ( DF/DHF ) have become a serious public health problem in many parts of India in recent years .']


Cluster  905
['In this parallel design randomized controlled trial, eligible enrolled term or term-corrected neonates (n = 56) in a level IV neonatal intensive care unit were randomized to receive either sucrose and swaddling or sucrose, swaddling, and vibration for heel lance analgesia.', 'Brief duration of 50% oxygen maternal inhalation during elective or emergency CS did not significantly affect foetal MDA and TAS under SAB.', "The results indicated that using the earmuffs reduces the level of noise in NICUs following by improving the preterm neonates' physiological stability and behavioral states of ABSS.", 'Infants between 26 and 36 weeks gestational age were randomised to receive either low-dose sedation (1\u2009mg/kg propofol intravenous) or no premedication during MIST procedure.', 'A serious problem during intensive care and nursing of premature infants is the invasiveness of many examination methods .', 'The effect of covering the eyes and playing the intrauterine ambient sounds in preterm infants may be recommended as simple, safe, and supportive stimuli that facilitate positive effects during painful procedures.', 'In this prospective, randomized, controlled trial 120 ASA physical status I-II, term pregnant women were recruited to elective CS (n = 60) and emergency CS (n = 60) and received either 50% oxygen or air inhalation following subarachnoid block (SAB).', 'Compared with epidural anesthesia, general anesthesia resulted in the lower S100β ratio of umbilical artery over the vein (medium 2.', 'S100β levels in newborn after C-section is lower with general anesthesia than epidural anesthesia, with unclear mechanisms.', 'Invasiveness of examination and therapy methods is a serious problem for intensive care and nursing of premature infants .', '68 infants (78 IHR) and 37 infants (44 IHR) received SA and GA at the discretion of the anesthesiologist, respectively.', "In this study, we aimed to identify the effect of covering the eyes and playing the intrauterine ambient sounds on premature infants' pain and physiological parameters during venipuncture.", 'Low-dose sedation increased comfort during MIST procedure in preterm infants, but the need for transient non-invasive ventilation was increased.']


Cluster  569
['Median depth compression using the distinct chest compression techniques varied and amounted to 26 [IQR, 25-28] mm for TFT, and 39 [IQR, 39-39] mm for TTHT as well as for nTTT.', 'The CSE has adequate precision and could be used for REE estimation for patients undergoing cardiopulmonary bypass if IC is unavailable.', 'CPF measurement by a ventilator was convenient, affordable, and safe.', 'We investigated the quality of chest compression when using the Cardio First AngelTM (CFA) feedback device compared to standard basic life support (BLS).', 'Chest compression as performed by laymen was significantly improved with regard to compression depth when using the CFA for guidance and feedback.', 'In pediatric patients undergoing diagnostic right and left heart catheterization, the MostCare<sup>®</sup> -PRAM was shown to estimate CI with a good level of agreement with the Fick method measurements.', 'It is a feasibility study to compare CC+SI\u2009versus 3:1 C:V ratio during neonatal resuscitation in the delivery room.', 'We performed a blinded prospective observational study of flow rates utilizing multiple resuscitation catheters.', 'Simultaneous use of all 3 ports of a TL CVC generates flow rates comparable to many other commonly used resuscitation catheters.', 'CFT<sub>C</sub> performs well compared to stroke volume measurements on a Vigileo monitor.', 'In this model of pediatric resuscitation, the SAD exchange using an ETTI has (LMA, Cobra PLA, Air-Q and SALT) proved to be effective in paramedics with no previous experience.']


Cluster  439
['This is a prospective randomized study.', 'This is a prospective, observational cohort study using a mixed-method approach.', 'Observational cohort pilot study.', 'The present study is an open, non-randomized, prospective cross-sectional observation study.', 'This is a prospective, observational cohort study.', 'Retrospective observational cohort study.', 'This is an analytic, observational, retrospective case-control study.', 'We carried out this single-center, prospective, randomized study between June and November 2016.', 'A cohort study.', 'This is a 6-year, single center, nonrandomized interventional study (2013-2019).', 'An observational cohort study.', 'A prospective observational case control study.', 'This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014.', 'A Cochrane systematic review.', 'This is an open-label, prospective, randomized, interventional, study.', 'Retrospective individual case-controlled observations and systematic review.', 'This is a sub-analysis from the prospective, cross-sectional and multicenter study (ClinicalTrials.gov Identifier: NCT03047603).', 'A retrospective epidemiological approach is used.', 'An observational case-control study.', 'Pilot observational cohort study.']


Cluster  1223
['The spread of intra-abdominal cancers is a vexing clinical problem for which there is no widely effective treatment .', "Colorectal cancer that develops as a complication of ulcerative colitis ( UC ) is a serious problem that affects the patient 's prognosis .", 'A total of 8615 and 3934 patients had a diagnosis of colon cancer and rectal cancer respectively.', 'There were 85 patients identified, with average age of 53\xa0±\xa012\xa0years, 69 (81%) with appendiceal or colorectal peritoneal cancer.', 'We aimed to assess the management and outcomes after multivisceral resections in patients with clinically infiltrative, locally advanced primary colon cancer.', 'Colonic neoplasms are quite a serious problem today .', 'This study included 65 patients with colon cancer treated with neoadjuvant chemotherapy in a phase II trial.', 'Metastatic colorectal cancer remains a serious health concern with poor patient survival .', 'As colorectal cancer and colorectal liver metastases become a serious public health problem , new treatment modalities are needed in order to achieve better results .', 'This retrospective, observational study on UESD for colorectal tumors included 26 colorectal tumors from 24 patients treated with UESD at our department between October 2015 and February 2017.', 'Colon cancer is a serious health problem , and novel preventive and therapeutical avenues are urgently called for .', 'Disseminated colon carcinoma metastases in the liver are associated with low cure rates and constitute a serious therapeutic problem .']


Cluster  1543
['A drawback of these approaches is they still require a manually labelled dataset for training , which is itself time-consuming to produce and still introduces an element of subjectivity .', 'A major drawback of existing discriminative methods is that samples are directly projected onto a subspace and hence fail to account for outliers common in realistic training sets due to occlusion , specular reflections or noise .', 'However , the major shortcoming is that the feature set , even with feature selection , may fit the labeled source data well but not the target data because the target data has no labels to be used in feature selection', 'However , a major drawback of this approach is the need to establish a correspondence across the training set .', 'The real drawback is the computational complexity of working with SVMs', 'One main problem with this approach is that these programs are written on a case-by-case basis because the data sets involved are heterogeneous in structure .', 'Their drawback is that , as most generative models , they are generally computed to maximize the joint likelihood of the training data', 'The drawback is that the estimates of parameters corresponding to events that occur infrequently in the training data are not reliable', 'A possible drawback is that for some inputs , the right output might not be available in the set considered by the training data , even if it might easily be constructed from known parts using a generative approach', 'A practical problem with this approach is that the amount of data required to confidently train such a regression model can be prohibitive .', 'The disadvantage is that it is likely to worsen the generalising power of the model']


Cluster  272
['While surgeon review of specimen radiographs can decrease the number of positive or close margins from 21 to 13%, more rigorous multidisciplinary, intraoperative margin assessment reduces the number of close or positive margins to 7%.', 'A common problem with lumpectomy is that the tumor may not be completely excised , and additional surgery becomes necessary .', 'Limitations of this study include its retrospective nature, and the reliance on the original diagnostic classification of each neoplasm.', 'In addition to the phenomena recognized as indicators of a serious clinical problem ( grade greater than I , rapid recurrence , multiple tumors and lamina propria invasion ) the identification of carcinoma in situ and/or atypia in normal , incidentally resected mucosa adjacent to the tumor was found to be a positive predictor for subsequent muscle invasion .', 'Although a high-grade tumor is the most important prognostic factor, preoperative diagnosis of the grade was not always accurate.', 'A total of 137 pedunculated polyps (size ≥1\u2009cm) in 116 patients were prospectively included and randomized into group A (with clipping) and group B (without clipping), and resected.', 'The borderline tumor is a serious diagnostic and treatment problem both for the pathologists and for clinicians .', 'The majority of polypectomy specimen margins were uninterpretable by pathologists for presence of residual neoplasia.', 'The interpretability of polypectomy specimens for presence of residual neoplasia at the margin was assessed by two blinded pathologists.', 'To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system.', 'A prospective observational study of 50 consecutive patients, with suspicious malignant/premalignant lesions.', 'Preoperative diagnosis of the histological grade by fine-needle aspiration cytology was only possible in 34% of the patients, while the histological grade was correctly determined by frozen section biopsy in 72%.', 'this finding is infrequent and is a serious problem for the surgeon who must solve the emergency and carry out the adequate surgical treatment with oncologic criterion .', 'A low TSR was found in 47% of the surgically resected primary tumors and correlated to a significantly higher T- and N-category compared, to tumors with a high TSR (p\u2009<\u2009.', 'Polyps of the gall-bladder has long been a serious diagnostic problem .']


Cluster  832
['At the start of rehabilitation, the control group and the OMT group had similar Visual Analogue Scale median scores (controls 4, interquartile range [IQR]: 2 to 5; OMT 4, IQR: 3 to 5; p\xa0= not significant) and mean inspiratory volumes (controls 825 ± 381 mL; OMT 744 ± 291 mL; p\xa0= not significant).', 'There were significant differences in the total Vancouver Scar Scale score between the first operation group (p < 0.', 'Clinical scores significantly improved from preoperative to follow-up.', 'Scores for the Modified Barthel Index (MBI), Mini-Mental State Examination (MMSE), Motor-free Visual Perception Test (MVPT), Line bisection test, Star cancellation test, Forward Digit Test, and Backward Digit Test showed significant improvement at the end of the sessions in the patient group.', 'The test group revealed significant reduction in postsurgery gain of levels of ALT, AST, and ESR compared with the control group.', 'As compared to preoperatively, the PSQI overall scores in both groups improved significantly postoperatively (P\u200a=\u200a0.', 'The mean postoperative IOP was statistically significantly lower than the mean preoperative IOP at each follow-up in each group.', 'Prospective clinical study showed that single longest CA impairment may result in post-operative deterioration of mental abilities.', 'There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value<\u20090.', 'There was poor to moderate agreement between recalled and collected preoperative scores for all patient-reported outcome measures.', "A significant difference was found between the intervention and control groups' NIPS score after venipuncture, which was primarily due to covered eyes' group.", 'There was no significant difference between groups for change in score from pre-operative to final follow-up in all three PROMs. Mean MIS and standard group improvement was: AKSS 53 and 51 (p=0.', 'Intragroup comparisons and group-rate analysis showed no significant impairment in overall neuropsychological performance, either postinterventionally or postoperatively.', 'At 1-year follow-up, clinical scores improved significantly (P\u2009<.', 'There was a significant difference between the 2 groups in the mean visual analog scale scores (at rest) at 6\u200ahours after surgery: 1.']


Cluster  461
['Malaria is a serious problem in the Brazilian Amazon region , and the detection of possible risk factors could be of great interest for public health authorities .', 'The reemergence of Plasmodium vivax in South Korea since 1993 represents a serious public health concern .', 'Hyperparasitemia itself might be important for the development of a fatal event in malaria , but a recommendation to perform a dangerous , expensive , and labor-intensive procedure such as blood exchange transfusion for its treatment should be based on substantial clinical research , especially in areas where malaria is a major health problem .', 'While malaria remains a serious public health concern , its rapid or prompt diagnosis in remote areas is important in the fight against the disease .', 'This study suggested the presence of autochthonous malaria transmission, in Pereira, between 2008 and 2015, most of which were cases of P. vivax.', 'Malaria is a serious global health problem , and rapid , accurate diagnosis is required to control the disease .', 'This retrospective observational study includes all patients admitted to the Infectious Diseases Unit and in the Pediatric Department of Padua (Italy), and discharged with a diagnosis of malaria from 2005 to 2015.', 'Malaria is a serious health problem in Colombia .', 'Plasmodium vivax can be transmitted through the transfusions of various blood components , which became a severe problem with the safety of blood transfusions and blood-related products in ROK .', 'Cerebral malaria ( CM ) is a life-threatening complication of Plasmodium falciparum malaria that continues to be a major global health problem .', 'This study aimed to describe the cases of malaria that were reported in the peri-urban areas of Pereira (Colombia), between 2008 and 2015.', 'Plasmodium vivax is a serious health concern in many regions and is sometimes inadvertently treated with sulfadoxine-pyrimethamine ( SP ) .', 'We identified all cases of malaria, resident in London, reported to the reference laboratory and obtained hospital admissions from Hospital Episode Statistics.', 'Malaria is a serious health problem in the states of Córdoba and Antioquia , Northwestern Colombia , where 64.4 % of total Colombian cases were reported in 2007 .']


Cluster  2341
['Although the reliability of data is a serious concern , we argue that there is a deeper and more insidious problem in the field : the persistent and dramatic misinterpretation of empirical results that replicate easily and consistently .', 'Overall, our study indicates pulmonology research is currently lacking in efforts to increase replicability.', 'The dissemination of findings is a crucial part of research', 'While a lack of research reproducibility has been identified as a serious and prevalent problem in biomedical research and a few other fields , little work has been done to examine the reproducibility of public health research .', 'Health researchers and funders are increasingly consulting with stakeholders to set their research agendas but these activities are rarely evaluated']


Cluster  2227
['Among the 37 enrolled infants, 14 (38%) had palatal groove.', 'Tongue biting in infants has a variety of aetiological factors and is a distressing problem .', 'Palatal groove formation induced by oral endotracheal intubation occurs with a high frequency in preterm infants, and this is likely to affect oral feeding ability.']


Cluster  1989
['In spite of several breakthroughs in the development of therapeutics to combat urinary tract infections and related diseases , the emergence of multidrug-resistant bacterial strains is a serious concern .', 'As strain variation and drug resistance become more pervasive , the prevention and control of infection have been a serious problem in recent years .', 'The higher frequency of multiple antibiotic resistance observed among the isolates , particularly isolates from HIV+Mal+ subjects , poses a serious public health concern as these strains may aggravate the prognosis of both UTI and HIV infection .', 'Nevertheless , antifungal resistant pathogens have increased during the past decade , becoming a serious concern .', 'However , reports of antimicrobial-resistant HVKP have increased over time , which poses a serious therapeutic dilemma .', 'Multi-resistant pathogens are a serious problem on a considerable scale for the health sector .', 'In recent years it has shown extraordinary ease in developing resistance to most antimicrobial agents , which is a serious problem as it makes these infections difficult to treat .', 'However , since its commercial release , K. pneumoniae resistance against tigecycline has been reported , and there is a serious concern about the spread of tigecycline resistant bacteria .', 'The growing drug-resistance profile reported in clinical isolates of C. albicans and non-C. albicans strains is a serious problem in hospitals worldwide .', 'The detection of multidrug-resistant isolates is a serious problem , jeopardizing an appropriate choice of treatment .', 'The biggest problem in infections with K.pneumoniae is that treatment options are limited due to multiple antibiotic resistance and consequently the increased morbidity and mortality .', 'Recent studies revealed that , notorious pathogens such as Salmonella typhi , Shigella dysenteriae and Vibrio cholerae have acquired multiple drug resistance and the treatment became a serious concern .', 'Multidrugresistant pathogens which are highly relevant for infection control in hospitals and other health-care facilities are a serious public health problem and a big challenge for all players in the health sector .', 'Although antibiotics to inhibit bacterial growth and small compounds to interfere with the productive life cycle of human immunodeficiency virus ( HIV ) have successfully been used to control HIV infection , the recent emergence of the drug-resistant bacteria and viruses poses a serious concern for worldwide public health .', 'Growing multiple drug resistance among gram-negative bacilli among hospitalized patients is a serious therapeutic problem , and the aim of the study was to assess the situation in our hospital .', 'The emergence of multiple-drug-resistant ( MDR ) strains of gram-negative bacteria causing urinary tract infection has become a serious concern in cancer patients .', 'The emergence of multiple-resistant isolates poses a serious problem in the hospital environment making it important to evaluate the responsible factors .']


Cluster  230
['Introduction of anticoagulant treatment led to a marked drop of these complications , while haemorrhage became a serious problem in their care .', 'Assess the hemostatic effect of topically applied brimonidine in patients being treated with anticoagulants and undergoing Mohs micrographic surgery (MMS).', 'Coagulation was activated after radical gastrectomy, as indicated by TEG analysis and the increased concentrations of plasma fibrin (fibrinogen) degradation product (FDP) and thrombin-antithrombin complex (TAT).', 'The Ankaferd blood stopper as a new strategy to avoid early complications.', 'Intraabdominal bleeding is a serious surgical problem , particularly in elderly patients following an anticoagulant therapy .', 'Although the treatment outcome is dramatically improved by all-trans retinoic acid ( ATRA ) , life-threatening bleeding from enhanced fibrinolytic-type disseminated intravascular coagulation ( DIC ) remains a serious clinical problem , and a standard treatment has not been established .', 'Hemorrhage is no longer a fearsome problem .', 'These findings confirm the safety profile and noninferior hemostatic efficacy of TachoSil compared with TachoComb.', 'The increased risk of hemorrhage associated with anticoagulant therapy following traumatic brain injury creates a serious dilemma for medical management of older patients : Should anticoagulant therapy be resumed after traumatic brain injury , and if so , when ?', 'All participants in the efficacy analysis (TachoSil: 54/54, 100%; TachoComb: 54/54, 100%) achieved hemostasis 5\xa0min after study treatment application.', 'A postauthorization safety study was performed between 2009 and 2012 to describe the use of Clottafact<sup>®</sup> in acquired fibrinogen deficiency in real-life medical practice in France.', 'A new fibrinogen concentrate Clottafact<sup>®</sup> was developed according to European guidelines on plasma-derived products.', 'Ankaferd blood stopper is a promising device for use in patent hemostasis, with no evidence on RAO at short-term or long term and with reduced risk of re-bleeding at the end of hemostasis.', 'However , there are clearly a number of inherited or acquired pathologies where hyperfibrinolysis is a serious , potentially life-threatening problem and a number of antifibrinolytc drugs are available to treat hyperfibrinolysis .']


Cluster  2073
['Hepatitis B virus ( HBV ) infection is a serious public health problem in many parts of the world .', 'Hepatitis B infection is a serious global public health problem .', 'Hepatitis B virus ( HBV ) infection affects 364 million people worldwide and causes a serious global public health problem .', 'Hepatitis B virus ( HBV ) infection remains a serious public health concern worldwide .', 'Hepatitis B virus ( HBV ) infection is a serious global health problem , with 2 billion people infected worldwide , and 350 million suffering from chronic HBV infection .', 'Hepatitis B is a serious public health problem across sub-Saharan Africa .', 'Hepatitis B virus ( HBV ) infection is a serious global public health problem affecting billions of people globally .', 'Hepatitis B virus ( HBV ) infection is a serious global health problem .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem worldwide .', "As one of the world 's most common infectious diseases , hepatitis B virus ( HBV ) is a serious worldwide public health problem , with HBV-associated liver disease accounting for more than half a million deaths each year .", 'Hepatitis B virus ( HBV ) infection is a serious public health problem worldwide .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem in sub-Saharan Africa pregnant women .', 'Hepatitis B virus ( HBV ) infection is known as a serious problem in the domain of public health and approximately 350 million people across the world are affected with this infectious disease .', 'Hepatitis B virus ( HBV ) infection is a severe health problem all over the world .', 'Hepatitis B virus ( HBV ) infection is still a serious public health problem .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem worldwide .', 'Hepatitis B virus ( HBV ) infection constitutes a serious global health problem .', 'Hepatitis B is a serious public health problem .', 'Hepatitis B is a serious public health problem throughout the world .', 'Hepatitis B is a serious global health problem .', 'Hepatitis B constitutes a serious public health problem .', "Viral hepatitis B is a serious health problem , above all in the world 's developing countries .", 'Hepatitis B infection is a serious health problem throughout the world .', 'Hepatitis B virus ( HBV ) infection constitutes a serious global health problem .', 'Hepatitis B virus ( HBV ) , a serious infectious and widespread human pathogen , represents a major health problem worldwide .', 'Hepatitis B virus ( HBV ) infection is a serious health problem not only in Egypt , but also worldwide .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem worldwide .', 'Chronic hepatitis B virus ( HBV ) infection due to perinatal mother-to-infant transmission ( MTIT ) remains a serious global health problem .', 'Hepatitis B virus infection is a serious public health problem .', 'Hepatitis B ( HB ) is a serious global public health problem .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem worldwide .', 'Hepatitis B virus ( HBV ) infection is a serious global health problem that is associated with huge social and economic costs .', 'Hepatitis B virus ( HBV ) infection is one of the most prevalent viral infections in humans and represents a serious public health problem .', 'This is a serious public health concern and a challenge for a country with high prevalence of hepatitis B infection .', 'Hepatitis B virus ( HBV ) infection is a serious health problem in the developing countries including Pakistan .', 'Hepatitis B virus ( HBV ) infection remains a severe public health problem .', 'Hepatitis B virus ( HBV ) infection is a serious global health problem .', 'Hepatitis A and B are still a serious global public health problem .', 'Hepatitis B virus ( HBV ) infection is a serious global health problem .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem , which can be transmitted through various routes ( e.g. , blood donation ) and cause hepatitis , liver cirrhosis and liver cancer .', 'Hepatitis B virus ( HBV ) infection is a serious , world-wide problem .', 'Hepatitis B ( HB ) is a serious global public health problem that put health professionals particularly at risk .', 'Hepatitis B is a serious global public health concern .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem in sub-Saharan Africa .', 'Viral hepatitis is a serious public health problem with hepatitis B virus ( HBV ) being one of its principle causes affecting billions of people globally .', 'Hepatitis B , a serious infectious disease caused by the hepatitis B virus ( HBV ) , remains a worldwide social and public health problem .']


Cluster  920
['The annual mortality rate was 24.', 'A single centre, cohort study of all unexpected deaths between 1 January 2010 and 31 December 2013.', 'The resulting " mortality gap " is a serious national problem , and it must be a high priority to understand the reasons for it and develop solutions .', 'Demographic and epidemiological changes go a long way in explaining shifts in place of death.', "To examine the effect of changes in decedents' age, gender and cause of death on the pattern of place of death using data on all deaths in Norway for the period 1987-2011.", 'However , certain proportion of patients died ( 9.52 % ) and defaulted ( 0.98 % ) , which is a serious public health concern that needs to be addressed urgently .', 'Population-based observation study comparing raw, predicted, as well as standardised shares of place of death isolating the effect of demographic and epidemiological changes.', 'The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October.', 'The absence of reduced total mortality in all series is a serious problem and evokes questions about the validity in determination of cause of death .', 'To assess temporal trends in potentially preventable deaths as a subset of total unexpected death rates over a 4-year period.', 'Premature death is a serious public health concern .', 'We used ten years combined mortality statistics from 2005 to 2014 and Welsh Index of Multiple Deprivation rankings for each lower super output area.', 'Mortality due to various causes , despite continuous efforts to improve the quality of medical services , is a serious problem for modern healthcare systems .']


Cluster  1329
["This study offers insights into nurses' behaviours and actions when they are interrupted and distracted during medicine administration.", 'To identify sources of interruptions and distractions to medicine administration rounds in hospitals.', 'Nurses were frequently interrupted and distracted, mainly by nurses and other healthcare professionals.', "The purpose of this study was to examine nurses' responses to interruptions and explore contextual factors that influence interruption management during medication tasks.", 'The findings of this study reveal that nurses are interrupted frequently during medication tasks.', 'Interruptions may lead to errors in nursing work.']


Cluster  246
['Given the close relationship between GH and IGF-1 , the long-term safety of GH treatment warrants a serious concern .', 'Patients with SHOX deficiency who had started GH treatment before puberty in routine clinical practice had a similar height gain to that of patients in the clinical trial on which approval for the indication was based, with no new safety concerns.', 'Body fatness is a serious problem starting in early childhood in CAH patients and further refinement of the glucocorticoid replacement regimens as well as lifestyle measures are needed .', 'Most SHOX-deficient patients in GeNeSIS had diagnoses of Leri-Weill syndrome (n = 292) or non-syndromic short stature (n = 228).', 'A potential drawback of GH replacement therapy in GH deficient ( GHD ) patients is the initial decrease in bone mass .', 'Metformin treatment in rapidly maturing girls with central adiposity normalized bone maturation.', 'Girls with low-birth weight (LBW) and postnatal weight catch-up tend to develop visceral and hepatic fat excess, which may be accompanied by an upregulated adrenarche with precocious pubarche (PP) and by a rapidly progressive puberty with early menarche and shorter stature.', 'In congenital adrenal hyperplasia (CAH), adjusting hydrocortisone dose during childhood avoids reduced adult height.']


Cluster  411
['However , as environmental PAH concentrations build up , this may be a serious concern around the incinerator vicinity due to the potential consequences of PAHs on ecosystems and human health .', 'Conclusively , this study demonstrates that environmental runoff is a serious concern , and thus , CBW incineration bottom ash should be treated carefully before disposal in landfills .', 'Additionally , the final process residues -- bottom and fly ashes containing high levels of heavy metals and dioxins -- also constitute a serious environmental problem .', 'However , environmental destruction due to the harvesting of wild licorice is becoming a serious problem .', 'The solid residues ( pulp , husk and parchment ) represent a serious environmental problem and do not have an adequate disposal mechanism .', 'The enormous amount of Ulva biomass thus becomes a troublesome waste disposal problem .', 'Palm oil mill effluent ( POME ) is a serious and expensive environmental problem in Malaysia .', 'The amount of the related wastes is estimated at up to 50,000 tons per year , representing a serious disposal problem with a consequent negative impact on the environment .', 'The problem with Taxol is that it is produced from a resource that is being rapidly depleted .', 'It is recalcitrant to degradation , and its accumulation is a serious problem with negative environmental impacts .', 'The large amount of vinegar residue has caused a serious environmental problem owing to its acidity and corrosiveness .', 'Disposal of pomelo peel after consumption is a serious environment problem .']


Cluster  143
['The ambiguous words of the corpus should be semantically tagged in advance.Table 3 lists some symbols presented by this paper . too many terms were identified , which in turn led to the aforementioned inflation in vocabulary size', '-LSB- SFB 100 is a research group in which different linguistic and computer science-oriented projects cooperate . some synonyms for a word do not carry the same sentiment orientation', 'The disadvantage is that many synonyms need to be discarded in order to achieve this property', 'fied by a name and a series of up to 9 numbers that indicate where in the thesaurus it appears . limited data', 'A weakness of the term recognition part is , however , that too many terms were identified , which in turn led to the aforementioned inflation in vocabulary size', 'avgwords is the average number of words for all articles . longer definitions are prefered over short ones', 'The ambiguous words of the corpus should be semantically tagged in advance.Table 3 lists some symbols presented by this paper . too many terms were identified , which in turn led to the aforementioned inflation in vocabulary size', '4the actual size of the filtered lexicon was 47,659 entries out of 53,015 entries of the original lexicon . incomplete sentences and wrong grammars', '4the actual size of the filtered lexicon was 47,659 entries out of 53,015 entries of the original lexicon . incomplete sentences and wrong grammars', 'That is , we need to fix a concept inventory and to use this inventory in a consistent way in particular , by assigning synonyms the same concept . it can not represent the link between arguments of a verb', 'One possible difficulty in using this automated procedure is that some synonyms for a word do not carry the same sentiment orientation']


Cluster  810
['We further extracted the tweets relating to seven significant events during the riot identified by UK newspaper The Guardian from this set of tweets . the need for large amounts of sense-tagged data', '-LRB- 2013 -RRB- investigates tweeting and retweeting behavior for political learning during 2012 US Presidential election . they are tied to the MacOS platform', 'The problem with Twitter data is that many papers receive zero tweets or only one tweet .', 'One problem with Twitter data , however , is that it contains a lot of noise .', '-LRB- 2013 -RRB- investigates tweeting and retweeting behavior for political learning during 2012 US Presidential election . they are tied to the MacOS platform', 'We further extracted the tweets relating to seven significant events during the riot identified by UK newspaper The Guardian from this set of tweets . the need for large amounts of sense-tagged data']


Cluster  2049
['At the end of the study, there were no significant differences between the groups.', 'For the primary outcome, no significant between-group difference was found.', 'There were no significant differences between the 2 groups with regard to physiological stability measured by the SCRIP score, means, and coefficient of variation as well as motor activity level.', "There was no significant difference in the patients' characteristics in the study groups.", 'There were no statistically significant differences in any of the demographic characteristics between both groups.', 'There was no baseline difference between the groups.', 'There was no significant difference in the development of morbidities between the groups (p = 0.', 'No statistically significant differences in parent outcomes were seen between groups.', 'There is no significant difference between groups, based on sex (P=0.', 'There were no significant differences in the baseline characteristics between the groups.', 'At baseline, there were no statistically significant differences between the HC and HE groups.', 'There were no statistical differences between groups at any time (p\u2009>\u20090.', 'There was no significant difference in the baseline performance of the two groups.', 'There was no significant difference between the two groups with regard to the mean age, sex, and initial iodine activity.', 'There were no statistically significant changes between group A and group B for baseline characteristics (p> 0.', 'No significant group differences were found for the PUL.', 'No statistically significant differences of demographic and clinical characteristics existed between the 2 groups.', 'No significant differences were found about demographic data between groups.', 'There was no significant difference in background characteristics between the 2 groups, except for parity, which was high in the RALUSLS group.', 'There were no significant changes in SOT or Mini BESTest in either group (p\u200a<\u200a0.', 'No statistically significant differences were identified in the number of stages per case between the 3 groups.', 'No significant relationship was found between these two groups of tests.', 'At baseline, there were no statistically differences between groups in terms of evaluated parameters (p> 0.', 'There were no statistically significant differences in characteristics between 2 treatment groups at baseline.', 'There were no statistically significant findings in knowledge for either group.', 'Although no significant differences were found between groups on any measure, there were significant intra-group changes for each group.', 'No significant differences were observed between the two groups, except for a few instances.']


Cluster  2149
['A serious concern with such treatments is that they may lead to the selection of drug-resistant strains .', 'The development of bacterial resistance is a probable drawback of such an intervention .', 'However , microbial colonization is a major drawback of these devices .', 'A possible drawback of this high promiscuity is that low-efficient strains can infect nodules as well .', 'A serious drawback of this strain , however , is its ineffectiveness against Gram-positive strains , such as the human pathogen Staphylococcus aureus .']


Cluster  5
['Japanese patients (N\xa0=\xa0105) were randomized 1:1:1 to omalizumab 300\xa0mg, 150\xa0mg, or placebo by subcutaneous injection every 4 weeks.', 'To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens.', 'In this double-blind phase 3 study, patients were randomised 3:3:2 to placebo (n=488), baricitinib 4\u2009mg once daily (n=487), or adalimumab 40\u2009mg biweekly (n=330) with background MTX.', 'Baricitinib provided significantly greater improvement in most PROs compared with placebo and adalimumab, including physical function MJS, pain, fatigue and quality of life.', 'Baseline mean NAPSI scores for patients treated with tofacitinib 5\xa0mg\xa0(N\xa0=\xa0487), tofacitinib 10\xa0mg\xa0(N\xa0=\xa0476), and placebo (N\xa0=\xa0233) twice daily were 27.', 'Patients (N\u2009=\u2009145) with active RA were randomized to placebo, 1mg, 2mg, 4mg, or 8mg baricitinib for the first 12 weeks.', 'Omalizumab dose and interval between administrations could be individualized for long-term management of CSU.', 'This post-hoc analysis of golimumab maintenance dosing [in the PURSUIT-M study] examined clinical outcomes and golimumab concentrations in early [Week 6] responders and nonresponders to induction, including subgroups based on body weight.', 'Compared with placebo, omalizumab 300 mg treatment over 12-24 weeks resulted in marked reduction in incidence and number of days/week with angioedema accompanied by clinically relevant improvement in QoL.', 'In nonresponders to golimumab induction [assessed at Week 6], the 100-mg maintenance dose [starting at Week 6] resulted in a meaningful proportion [28.', 'In 2 identical phase 3 studies (OPT Pivotal 1 and 2), patients were randomized 2:2:1 to receive tofacitinib 5\xa0mg, tofacitinib 10\xa0mg, or placebo, twice daily.', 'In nonresponders to golimumab induction for ulcerative colitis, we assessed clinical response rates and golimumab serum concentrations when the 100-mg dose was used early in the course of maintenance.', 'Assessment of ustekinumab serum levels at week 6 could provide useful information in routine clinical practice.']


Cluster  1750
['282 patients (mean age 70.', 'We identified 241 patients with a mean age of 67 years.', "The patients' backgrounds were as follows: median age (range), 62 (37-75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31.", 'A total of 106 patients (68F, 38M) with a mean age of 49.', 'Of 139 patients included in our study, 102 were male with median age of 49 years (IQR:28-64).', 'A study of 260 patients with a mean age of 70.', '120 patients with an average age of 58.', 'Between February 2002 and December 2013, 788 patients (aged 67.', 'A total sample of 150 patients, mean age 49.', 'Twelve patients (67% males, mean age 74 SD\u2009±\u200915.', 'In all, 2051 patients [median (range)], aged 41 (1-101) years, 72.', 'A prospective cohort study of 100 patients (26 men and 74 women, at a mean age of 79.', 'In the present study, 24 patients (age 34.', '95 female patients were eligible for questionnaire analysis (median age 58 years).', 'Included in this study were 17\xa0patients, 6\xa0women and 11\xa0men, with a\xa0mean age of 58 years (19-87).', 'In a prospective randomised study, 109 patients (mean age 65.', 'Between January 2005 and December 2012, a retrospective study on age-, gender-, and EuroSCORE-matched patients aged 70 years and older was performed.', 'Single-blind randomized controlled trial, 24 patients (54% male), mean age (65±4.', 'A total of 108 patients were enrolled in the study; 94 females and 14 males with mean age of 38.', 'the study included 131 patients aged 21-91 years (mean 63.', 'The study involved 480 patients with an average (SD) age of 35.']


Cluster  796
['In the case squares, the mean number of terminal and vellus hairs was 87 and 43 at the beginning and 85 and 42, respectively, at the end of six months.', 'We found that the main effect of cetirizine was an increase in total hair density, terminal hair density and diameter variation from T0 to T1, while the vellus hair density shows an evident decrease.', 'Initially, there was no significant difference between the numbers of hair follicles.', 'The mean time to first response in terms of new hair growth was 3 months and the mean time to maximal response was 9 months.', 'The problem with this explanation is that , like mammalian hair , simple feathers could serve as insulation only when present in sufficiently high concentrations .', 'Coat damage has been reported frequently in captive rhesus macaques ( Macaca mulatta ) , and it is a serious health problem because the hair coat functions as an anatomic and physiologic barrier between the animal and the environment .', 'The problem with this postulate is that the electrical source and mechanical load for the electromechanical outer hair cell might be severely attenuated and phase-shifted by the electrical impedance of the cell and the mechanical impedance of the organ of Corti , respectively .', 'Hair mass index or hair count did not statistically significantly differ between the study and placebo groups.']


Cluster  2000
['US assisted percutaneous liver biopsy, although more costly, but may be safer to perform particularly in younger age.', 'Liver biopsy remains the most reliable method to diagnose various hepatic disorders in children.', 'Another important problem associated with NASH is that presently the liver biopsy is still the gold standard in diagnosis and for disease staging and grading .', 'Nonalcoholic fatty liver disease ( NAFLD ) has become a serious public health problem worldwide ; however , the availability of information on the prevalence of NAFLD in the general pediatric population is still limited .', 'The lack of sensitivity to detect fibrosis , because of its heterogeneity is a drawback of liver biopsy ( LB ) .']


Cluster  764
['Dormant conduction (i.e., the reappearance of PV potentials during at least one beat) was seen in 1 out of 96 PVs (1%).', 'However , a common and significant drawback of the CPMA is related to crosstalk issues between cells by sneak currents .', 'If a large number of input sources intermittently converge on a cell through time , then a serious design problem arises : if cell activities are sensitive to large inputs , then why do not small inputs get lost in internal system noise ?', 'The resistance change that takes place when a cell passes through the sampling orifice is only a small fraction of a percent , thus noise is a serious problem .', 'However , a major drawback of hPSC-CMs as a model system , especially for electrophysiological studies , is their depolarized state and associated spontaneous electrical activity .', 'However , a significant common drawback of the CPA configuration is the crosstalk between cells .']


Cluster  2057
['Air pollution from road traffic is a serious public health problem .', 'Air pollution has become a severe environmental problem due to urbanization and heavy traffic .', 'Air pollution is a serious public health concern .', 'Air pollution in cities is a serious environmental problem especially in the developing countries .', 'Air pollution , which started to become a serious health concern with industrial revolution , has been threatening human health .', 'Air pollution has become a serious public health problem for many cities around the world .', 'Air pollution is a severe problem in major urban areas due to increasing numbers of vehicles , reduced road capacity and few investments in public transportation , especially in developing countries .', 'Air pollution is a serious environmental problem .', 'Outdoor air pollution is a serious environmental problem worldwide .', 'Outdoor air pollution is a serious problem in many developing countries today .', 'Urban air pollution is a serious worldwide problem due to its impact on human health .', 'Air pollution is a serious health problem in almost all developing and developed countries around the world .', 'Air pollution is a serious problem in many countries in Southeast Asia , particularly in major metropolises with high levels of traffic congestion generating significant amounts of genotoxic substances .', 'Transboundary transport of air pollution is a serious environmental concern as pollutant affects both human health and the environment .', 'Furthermore , air pollution also remains a serious concern in many global regions , requiring the application of appropriate treatment technologies to mitigate the respective negative effects on human health and environment .', 'Urban air quality is a serious problem , with an estimated 40 million people in Europe exposed to exceedences of existing WHO air-quality guidelines , with prospects of further declines in air quality due to projected growth in motor vehicle traffic .', 'Due to intense industrialization and urbanization , air pollution has become a serious global concern as a hazard to human health .', 'Although air pollution is a serious problem in Ahvaz , the association between air pollution and respiratory diseases has not been studied enough in this area .', 'The objective of this study was to investigate the environmental levels , emission sources , seasonal variations and health risk of eleven PAHs in the two cities , especially Ho Chi Minh City where air pollution is becoming a serious concern .', 'Nowadays , a large number of health endpoints such as disease rates , treatment costs , and death , by air pollutants , have been a serious health problem for humans .', 'Air pollution is a serious environmental problem .', 'Air pollution has become a serious public health problem globally .', 'Air pollution is a serious problem globally , especially in developing countries that causes health problems to humans and damage to the ecosystem .', 'Air pollution is a serious problem that affects billions of people globally .', 'Due to the rapid development of industrial society , air pollution is becoming a serious problem which has being a huge threat to human health .', 'Exposure to ambient air pollution is a serious and common public health concern associated with growing morbidity and mortality worldwide .']


Cluster  1763
['Independently of the modality of treatment , pain was not a serious problem reported by the patients during the follow-up .', 'Both methods were safe and effective with minimal side effects.', 'No patient reported adverse effects related to the treatment received.', 'No dropout and adverse effect was observed during the study.', 'There were no significant differences between the preparations in terms of efficiency or safety though Crinone 8% was better tolerated.', 'There were no residual stones observed in the 2 groups.', 'No nodules were reported by subjects or detected by the blinded evaluator regardless of massage status.', 'None of the subjects had signs of hypersensitivity and all continued in Phase II.', 'Adverse drug reactions were not a serious problem .', 'At 90 days, no pain was reported, irrespective of smoking habit.', 'There were no major complications in the study.', 'There were no serious adverse events in the elderly, and the rate of adverse events between the non-elderly and elderly was not different.', 'No patient reported a severe problem with postoperative pain or mobility .', 'Residual pain at the osteotomy site was not a serious problem .', 'No significant operative or postoperative complications (other than failure) were encountered in either group.', 'We found no differences in sensory block duration between the 5 groups.']


Cluster  833
['Being a globally emerging mite-borne zoonotic disease , scrub typhus is a serious public health concern in Nepal .', 'Mortality rates of up to 80 % in infected infants have been recorded making C. sakazakii a serious cause for concern .', 'Careful examination for eschar in children presenting with fever, particularly in the skin folds of the groin, genitalia, and axillae, can aid in early diagnosis of scrub typhus.', 'We examined the occurrence of Simkania negevensis in two differents populations, both characterized by a high susceptibility to infectious complications: 105 hemodialysis patients, 105 renal transplant recipients and 105 healthy subjects through the IgG and IgA response to Simkania negevensis in their sera.', 'Up to 80 % of infants infected with Cronobacter sakazakii die within days of birth , making this emerging gastrointestinal pathogen a serious cause for concern .', 'Scrub typhus , a serious public health problem in the Asia-Pacific area , is endemic in the " tsutsugamushi triangle " area .', 'Although infections due to the six ESKAPE pathogens have recently been identified as a serious emerging problem , information regarding bacteremia caused by these organisms in solid-organ transplant ( SOT ) recipients is lacking .', 'Infection due to the six ESKAPE pathogens has recently been identified as a serious emerging problem .']


Cluster  2066
['Pretreatment using fractional Er:YAG laser before topicals might be an effective method for drug delivery.', 'Greater reduction in the size and increase in pigmentation score was seen in Er:YAG group especially for short periods after therapy and repeating laser sessions may help improving final outcomes.', 'To determine the efficacy and safety of a variable square pulse Erbium: YAG (VSP Er:YAG) laser for the treatment of striae in skin phototypes III-IV.', 'Our results suggests that Er:YAG laser could be a promising option for the treatment of OL.', 'Adding topical silicone gel to ablative Er:YAG laser treatment may provide additional benefits in improving acne scars.', 'Thirty patients with atrophic acne scars were randomly treated in a split-face manner with a fractional Er:YAG laser on one side and microneedling on the other side.', 'The use of Er:YAG laser reduces pain and allows minor surgical procedures to be carried out without anesthesia.', 'To compare the efficacy and safety of the ablative fractional Er:YAG laser and microneedling for the treatment of atrophic acne scars.']


Cluster  473
['Respondents perceived that CRCD is a serious problem and identified the following needs areas : general CRCD education , diagnostic skills , knowledge regarding behavioral and pharmacologic interventions , and availability of adequate CRCD practice protocols .', 'Reliable reductions and a large effect size indicated that CBT-P was associated with improvements in perfectionism and OCD severity at post-test.', 'We aim to evaluate rIPGs in OCD in terms of effectiveness, applicability, safety, and need for IPG replacement.', 'Obsessive-compulsive disorder is a serious clinical problem in childhood and practitioners , pediatricians , and psychiatrists should explicitly ask about the presence of symptoms characteristic to obsessive-compulsive disorder .', 'Obsessive-compulsive disorder ( OCD ) is a serious mental health problem that causes significant impairment and reduced quality of life .', 'Forty-two OCD patients underwent cET treatment.', 'In 3 patients with treatment-resistant OCD, DBS electrodes were implanted in the bed nucleus of the stria terminalis (BNST)/internal capsule (IC).', 'Obsessive-compulsive disorders and disorders within their spectrum pose a serious diagnostic and therapeutic problem , as the symptoms that appear along with the disorders result from dysfunction of the emotional , motivational and cognitive sphere .', 'This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n\xa0=\xa029) or CBT (n\xa0=\xa026).', 'Across locations, low voltage stimulation (1 and 2 V) was associated with reduction of OCD symptoms (i.e., anxiety and tension), in particular when the IC was stimulated.', 'In summary, we demonstrate that both stimulation site and voltage settings show sweet spots (2 V at IC or BNST/IC) at which OCD symptom severity decreased while negative effects were minimal.', 'To pilot-test the efficacy of group CBT for perfectionism in participants with OCD and elevated perfectionism.', 'The primary aims of the present study were to evaluate the treatment results for a new sample of OCD patients receiving the cET treatment approach and to replicate the effectiveness study described in Havnen et al.']


Cluster  1660
['This is a serious problem , particularly considering that populations of several commercially exploited fishes are declining and some exhibit recruitment problems .', 'Overexploitation of commercially beneficial fish is a serious ecological problem around the world .', 'The severity of disturbances and the possibility of a serious behavioural problem for fish across the globe is cause for concern .', 'This raises a serious concern because these fishes are consumed by the local populations and hence would ultimately affect human health .', 'Destructive fishing methods such as drag nets and dynamite fishing pose a serious problem as they destroy important habitats for fish and other organisms , and there is a long-term trend of overharvested fishery resources .']


Cluster  1968
['Fifty-five consecutive children suffering from FC were randomly assigned into two groups: group A received a daily oral combination of PEG plus PM and group B received oral PEG only.', 'PEG and PEG\u2009+\u2009PM are equally effective and safe in the treatment of children with chronic constipation.', 'Prospective observational study on adult PEG fed patients.', 'Over a 3-year period, 214 children were randomized (PEG, 107; RIG, 107), of whom 100 received PEG and 96 RIG.', 'No statistically significant differences in the modified Chicago BPS were found among Gatorade and 357 g of PEG given as a day-prior dose and the 3 split-dose arms with 98.']


Cluster  1368
['Rabies is a fatal viral zoonosis and a serious public health problem .', 'Rabies is a fatal viral zoonosis and a serious public health problem .', 'Rabies , a fatal encephalitis of viral origin , is still a major health problem in the developing world .', 'Canine rabies , responsible for most human rabies deaths , is a serious global public health concern .', 'Rabies , a zoonotic viral encephalitis , continues to be a serious public health problem in India and several other countries in Asia and Africa .', 'Human animal-bite injuries are a serious public health problem due to associated risk for rabies virus exposure .', 'Canine rabies remains a serious public health problem in Thailand .', 'Rabies is a serious concern world-wide .', 'Rabies is a fatal neurological disease and a persistent global problem .', 'Rabies is a serious public health problem in Asia .', 'The cases of rabies increase greatly in recent years in China and rabies continues to be a serious problem in developing countries due to the reservoirs of Rabies virus in dogs and wildlife vectors .', 'Rabies is a fatal disease once contracted , and a serious public health problem .', 'Canine rabies is a serious health problem in Morocco and about 22 human deaths are reported yearly . Following the World Health Organization ( WHO ) recommendations , Moroccan authorities evaluated oral rabies vaccine baits specially designed for dogs .', 'Rabies is a fatal viral zoonosis and a serious public health problem .', 'Rabies remains a serious public health problem in many developing countries .', 'Rabies continues to be a serious problem in both developed and developing nations due to the reservoir of rabies virus in wildlife vectors .', 'Rabies is a serious concern to public health and wildlife management worldwide .', 'Because of its association with dogs , rabies virus ( RABV ) is still endemic in Thailand , where it is a serious public health problem .', 'Rabies is a fatal acute viral disease of the central nervous system , which is a serious public health problem in Asian and African countries .', 'In this ecosystem , paralytic rabies is a serious economic problem because of its frequency and readiness to spread ( 41 separate outbreaks were recorded in addition to an epidemic ) .', 'Rabies poses a serious public health concern in developing countries such as India .']


Cluster  890
['Opioid Use disorders are emerging as a serious public health concern in India .', 'Even originally introduced as efficient anesthetic drugs to relieve moderate-to-severe pain in clinic , the overdose of new synthetic opioids is currently a serious public health problem in numerous countries worldwide .', "Considering fentanyl 's high potency and abuse liability , the recent rise in fentanyl-related deaths is a serious public health concern and signifies the urgent need to establish prevention and treatment efforts .", 'The opioid crisis has led to increasing numbers of overdose fatalities in teens and young adults.', 'Opioid addiction and overdose is a serious problem worldwide .', 'With thousands of people in the United States dying of opioid overdose each month , the opioid epidemic has become a serious public health concern .', 'Frequent use of opioid analgesics with other DIMs is a serious problem for drivers and increases the risk of accidents .', 'Opioid use is a severe problem in Iran .', 'Prescription opioid abuse and addiction , along with consequences such as overdose death and increasing transition to heroin use , constitute a devastating public health problem in the United States .', 'Prescription opioid and heroin abuse have been increasing steadily year after year , and continue to be a serious national problem .', 'Opioid abuse remains a serious public health problem .', 'The opioid epidemic has become a severe public health problem , with approximately 130 opioid-induced deaths occurring each day in the United States .', "Prescription opioid misuse in Canada has become a serious public health concern and has contributed to Canada 's opioid crisis .", 'Prescription opioid misuse and abuse is a serious public health concern that can lead to overdose , addiction , and death .', 'Misuse of opioid analgesics and other psychoactive medicines is a serious and increasing problem in Australia .', 'Prescription opioid abuse has become a serious national problem .', 'Overdose is a serious problem as for people addicted to opioid drug injections ( ODI ) as well as for the community in general .', 'Prescription opioid abuse poses a serious problem in the United States , representing', 'Over the last two decades , opioid-related mortality rates have increased dramatically to become a serious public health concern in the United States .', 'Opioid addiction , also referred to as opioid use disorder , continues to be a devastating problem throughout the world .', 'Nonmedical use may lead to opioid abuse/dependence , a serious public health concern .', 'The opioid epidemic continues to be a serious public health concern .', 'Prescription opioid abuse and misuse are a serious problem in the U.S. today .', 'The abuse of opioids is a serious and prevalent problem and research is needed on factors that may place individuals at risk for misusing opioids .', 'Opioid addiction is a serious public health concern with severe health and social implications ; therefore , extensive therapeutic efforts are required to keep users drug free .', 'Opioid use disorders are considered a serious public health problem among young adults .', 'The current opioid crisis has created a tragic problem in medicine and society .', 'The opioid epidemic is a severe problem in the world , especially in the United States , where prescription opioid overdose accounts for a quarter of drug overdose deaths .', 'Nonmedical prescription opioid use ( NMPOU ) is a serious public health problem in North America .', 'Misuse of opioid analgesics , in combination with diversion , dependence , and fatal overdoses , presents a serious problem for public health , which affects many countries worldwide .']


Cluster  1782
['In Mexico it is now recorded in 12 states and represents a serious public health problem , given the recent introduction of Chikungunya on the southern border .', 'There is a serious gap in the official epidemiological information ; placing the real problem in perspective would help to establish the adequate public policies for both , prevention and investigation of the causes of SD in Mexico .', 'Chile has a serious public health problem due to the high prevalence of both unhealthy dietary patterns and mental illnesses .', 'Lack of disease awareness is clearly a serious problem among recent Mexican immigrants .', 'In Latin America is a severe public health problem .', 'PE represents a severe medical problem in South America .', 'This situation nowadays has become a serious public health problem in big Latin American conurbations .', 'There is a serious gap in the official epidemiological information ; placing the real problem in perspective would help to establish the adequate public policies for both , prevention and investigation of the causes of SD in Mexico .']


Cluster  801
['Moreover , this virus poses a serious threat to immunocompromised people , which is a significant problem nowadays due to the increasing number of patients undergoing immunosuppressive therapy .', 'Epidemic outbreaks of both visceral and cutaneous forms of the disease have become a serious concern in view of such events occurring in neighboring countries .', 'This virus subsequently spread to 27 countries with a total of 939 deaths and 2586 confirmed cases and now has become a serious concern globally .', 'This virus has now been spread to 27 countries with a total of 858 deaths and 2494 confirmed cases and has become a serious concern for the human population .', 'Recently , this virus has become a serious concern because of consecutive epidemics in the Asia-Pacific region .', 'Hantaan virus ( HTNV ) infection in humans is a serious public health concern in Asia .', 'Coxsackie virus A16 ( CVA16 ) infections have become a serious public health problem in the Asia-Pacific region .', 'There is a serious concern that the virus may spread to other areas , such as North America and Europe .', 'In the past decade the disease has been recognized as a serious problem in 19 provinces of China and in Japan , where the virus is the Hantaan virus .', 'Recently , invasive illness from this common pathogen has become a serious clinical problem in the region .', 'The recent outbreak of Chikungunya virus in Italy represents a serious public health concern , which is attracting media coverage and generating public interest in terms of Internet searches and social media interactions .', 'This disease , which can manifest as a severe respiratory infection , has been declared as a public health emergency of international concern and is being treated with a variety of antivirals , antibiotics and antifungals .', 'Chikungunya virus is recognized as a serious public health problem .']


Cluster  1030
['Suicidal behavior is a serious public health problem which is partly heritable .', 'Although communication is a key component of US strategies to prevent suicide and there are a number of marketing campaigns promoting messages that suicide is a preventable public health problem , there has been little evaluation of these campaigns .', 'Suicide is a significant public health issue', 'Suicide is a serious public health problem , including among U.S. Army personnel .', 'To mitigate such a serious public health problem , identifying the risk or protective factors of suicide behaviors is crucial .', 'Suicide is a serious public health concern , but little is known about the relationship between access to mental health care and suicide deaths , and whether suicide rates differ by mental health provider Health Professional Shortage Areas ( HPSAs ) .', 'Suicide claims one million lives worldwide annually , making it a serious public health concern .', 'Suicide is a complex issue', 'Suicide is a serious public health problem in low- and middle-income countries .', 'Death by suicide is a preventable public health concern worldwide .', 'Suicide is a serious and global health problem that has a strong association with major depressive disorder ( MDD ) .', 'Suicide is a leading cause of death and represents a serious public health concern .', 'Suicide is a serious public health problem , being , according to WHO , a third leading cause of death among people aged 15 - 44 .', 'Suicide is a devastating public health problem and very few biological treatments have been found to be effective for quickly reducing the intensity of suicidal ideation ( SI ) .', 'Suicide is a serious public health problem worldwide .', 'Suicide has become a serious and growing public health problem in many countries .', 'Suicide is a serious public health problem in many countries and has always been a source of apprehension and quest to human mankind , which can be resolved with due diligence .', 'Suicide is a serious problem globally , especially in Europe , with suicide rates varying between different countries .', 'Suicide is such a serious public health problem that it has been proposed as an indicator of mental health of a society .', 'Suicide is a devastating public health problem , and research indicates that people with prior attempts are at the greatest risk of completing suicide , followed by persons with depression and other major mental and substance use conditions .', 'A change in media trend toward reporting suicide was noted post a celebrity suicide , and it is important that media follow guidelines stringently when reporting a serious problem like suicide .', 'Global suicide rates have increased in recent decades becoming a serious social and public health problem .', 'Suicidal behaviours are internationally considered as a serious health problem and , consequently , considerable efforts are being made in the search for factors related with this behaviour .', 'Suicide and attempted suicide are identified as a serious mental health problem in Suriname , especially in the district of Nickerie .', 'Although hospitalization rates for attempted suicide have declined in Brazil , it remains a serious public health problem .', 'Despite its decreasing tendency , suicide risk is still a serious problem facing our health care system .', 'The economic and human cost of suicidal behavior to individuals , families , communities , and society makes suicide a serious public health concern , both in the US and around the world .', 'Suicide is a serious public health concern in Alberta , with , on average , over 400 Albertans taking their own lives annually .', 'Suicide is a serious public health problem around the world .', 'Suicide is a serious public health problem but a problem that is preventable .', 'Suicidal behaviour still represents a serious public health problem .', 'Suicide is a preventable public health problem and a leading cause of death in the United States .', 'Suicide is a serious social and public health problem .', 'Suicides and suicidal behaviors are very important causes of mortality and morbidity and have become a serious global problem .', 'Suicide is a serious public health problem , and training in suicide prevention has not kept pace with recent rapid growth of the field .', 'Suicide is a serious public health problem worldwide , and many nations are committed to developing prevention programmes to reduce the incidence of suicide .', 'Suicide is a preventable health problem .', 'Suicide and suicide attempts represent a severe problem for public health services .', 'Suicide is a serious and increasing problem worldwide .', 'Suicidal behaviour constitutes a serious public as well as mental health problem all over the world .', 'Death by suicide is a serious and growing public health concern in the United States .', 'Women and Suicide : Moving Forward on a Troubling Problem .', 'Suicide is a serious public health problem in Mato Grosso do Sul , and has had an alarming and disproportionate impact on the indigenous population for more than a decade .', 'Suicide is a serious public health problem .', 'Suicide is a serious public health concern .', 'Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity.', 'Suicide is a serious public health problem , with more than 800,000 deaths taking place worldwide each year .', 'Suicide is a preventable public health problem .']


Cluster  517
['This randomised controlled trial with two parallel groups aimed to explore the effectiveness of osteopathic treatments (OTs) on these conditions.', 'Compared with placebo saline injection, using IBTA to treat plantar fasciitis resulted in significantly better improvement in foot function and pain.', 'Plantar fasciitis is a debilitating and painful problem present in the general population .', 'Treatment with an emollient is effective for improving foot xerosis in patients with diabetes.', 'This study aimed to assess the efficacy of an emollient cream on foot xerosis in patients with diabetes.', 'The EVerT2 (Effective Verruca Treatments 2) trial aimed to evaluate the clinical and cost-effectiveness of the needling procedure for the treatment of plantar verrucae, relative to callus debridement.', 'Many treatment options for plantar fasciitis currently exist, some with great success in pain relief.', 'This single-centre randomized controlled trial recruited 60 participants (aged ≥ 18 years with a plantar verruca).', 'We conducted a double-blinded randomized controlled trial at a tertiary pediatric orthopaedic center on 33 children (average age=17.']


Cluster  1325
['Gesture precedes vocabulary development and may be an early marker of later language impairment.', 'At baseline, social gradients were observed in caregiver contingent talk to their 11-month olds (but not in infant communication).', "Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, this study examined the contribution of children's (N=1064) early gestures and early vocabularies to their risk of language impairment in preschool years.", "At age 15 months, maternal reports on children's use of gestures and vocabulary comprehension and production skills were measured using the MacArthur Communicative Development Inventories.", "The effect of early gesture on children's later risk of language impairment was indirect and mediated by early vocabulary production."]


Cluster  17
['Our study demonstrates that patients treated with thrombolysis experience greater improvement in language than the nontreated patients.', "The preliminary findings suggest that using parents to facilitate their child's pragmatic language skills was a feasible intervention approach with parents acting as agents of change to improve the pragmatic language of their children.", 'The data indicate that RSI is a severe problem among sign language interpreters and warrants immediate action .', 'We conducted a randomized controlled trial with 394 children in England, comparing a 30-week oral language intervention programme starting in nursery (N\xa0=\xa0132) with a 20-week version of the same programme starting in Reception (N\xa0=\xa0133).', 'Both the 20- and 30-week programmes produced improvements on primary outcome measures of oral language skill compared to the untreated control group.', 'Among patients with SRA, compared to a sham condition, adjuvant rTMS improved speech and language skills.', 'A total of 12 patients (mean age: 55 years; right-handed; 7 women) underwent treatment for SRA 1 month after stroke.', 'Role-play as a therapy approach targeting two pragmatic skills, stylistic variation and requesting for clarification, was found to be beneficial for learners with LLD.']


Cluster  712
['The mean age of the sample was 18.', 'Included were 16 men and 26 women with a mean age of 24.', 'Mean age was 24, and 68% were men.', 'Seven hundred and thirty-two individuals (463 women, 269 men; M <sub>age</sub>\u2009=\u200940.', 'The majority were female (57.', 'Thirty athletes (mean age 38.', 'The mean age was 38.', 'Sampling age was 41.', 'Thirteen men and 16 women were enrolled with an average age of 61.', 'Forty-four healthy adults (95% white; 57% male) were included.', '48,634 elderly (≥65\xa0years) were included.', 'Those with young MI accounted for 12.', 'The sample was primarily Caucasian (86.', 'A total of 59\xa0women and 41\xa0men with an average age of 70.', 'The survey was completed by 1054 beachgoers, with a mean age of 43.', 'Mean age was 69 years, with 36% female.', 'Mean age was older in the 2002 group than in the 2012 group (67.']


Cluster  1734
['The small sample size in the studies was a serious shortcoming reducing the statistical heterogeneity and obscuring differences in outcome between drugs and between experimental conditions .', 'Few publications included statements regarding materials (10%), protocols (1%), data (15%), and analysis script (0%) availability.', 'This study was limited by the lack of a placebo group and a small sample size.', 'One major problem with those previous studies is that the numbers of characters and OTUs were small .', 'These data should be considered preliminary because of a small sample size.']


Cluster  293
['Ten patients undergoing platysma sparing submental lymph-node flap harvest were prospectively enrolled in the study and compared with a control group of 10 patients who underwent standard submental lymph-node flap harvest.', 'Provided that early and completed debridements of contact points of HVEB were achieved, distally based sural flap is feasible and there is reliable coverage in HVEB even in patients with flap pedicle located in vicinity of the zone of injury.', 'ICG angiography is a feasible and safe technique for the detection of free flap vascular complications.', 'Root coverage (RC) procedures such as lateral positioned flap (LPF) have been used since long time but with limited success and specific indications.', 'A total of 51 patients with contact point of high-voltage electrical burn (HVEB) in distal leg and foot undergoing distally based fasciocutaneous sural flap were included in this prospective clinical study.', 'The results of this prospective interventional trial could not detect any negative impact of vasopressors, neither for the primary endpoint of flap survival nor for the overall patient outcome.', 'In Group 3 , there was a severe reduction of blood flow in the flap and no flaps survived ; however , all the flaps in Group 2 survived totally with no problem .', 'The vascular complication rate was 15% (3/20) with 2 cases of venous thrombosis and one case of partial necrosis of the flap skin paddle.', 'Forty geometrically modified PAP flap reconstructions were performed on 30 patients.', 'Flap necrosis due to blood circulation disorders is a serious problem in reconstructive surgery .', 'The use of quilting donor sites significantly decreases the incidence of donor-site seromas and leads to earlier drain removal following latissimus dorsi flap reconstruction and maintains a low complication profile.', 'Recurrence of pressure ulcers is a serious problem following myocutaneous flap surgery and can lead to prolonged and expensive hospitalization .', 'After 10 years of follow-up, there were changes in chest wall-based flap bottoming-out in patients in whom a pectoralis major muscle sling was utilized compared with those patients without it.', 'There was one total flap failure with liberal fluid administration (LFA).', 'Random-pattern skin flaps are used widely in plastic surgery , but necrosis resulting from ischaemia in the distal sections of the flap is a serious problem .', 'Necrosis of surgically transferred flaps due to ischemia is a serious wound problem .', 'Due to its consistent vascular and lymphatic anatomy, the vascularized submental lymph node flap is a reliable option for lymphedema treatment.', 'The clinical success rate (Bergland types I and II) of the Scarpa fascia procedure was significantly higher (67.', 'R esults ( selected corner points ): 1 ) Biological protection procedures in vascular surgery by flap coverage after meticulous debridement with or without autogenic vascular reconstruction are used to overcome infection of a vascular prosthesis , a serious problem , associated with the risk of anastomotic rupture and bleeding by transfer of immunological competence due to tissue coverage and finally to induce healing in the area of an infected vascular prosthesis .', 'Patients in subgroup S had a significantly higher difference in migration of the chest wall-based flaps between the first day and 10 years postoperatively when compared with patients in subgroup C (P < .', 'Fluorescence in the pedicle vein after ICG intradermal injection indicates functional intratissue LVC in free flaps.']


Cluster  2041
['Unilateral postburn cervical deformity is a severe cosmetic and functional defect and a challenging reconstructive problem .', 'Postburn cervical contractures involving the anterior neck represent a serious social , public , and medical problem .', 'Neck and axillary burn contractures are both a devastating functional and cosmetic deformity for patients and a challenging problem for reconstructive surgeons .']


Cluster  641
['In multivariate regression analysis, NMSC resulted significantly associated with age (OR: 1.', 'Six men and five women were included in the study.', 'Forty-three female participants (Mean±SD: 14.', 'Sixty-nine participants (87%) completed the study (standard, n=34; BFR, n=35).', 'Thirty-five female subjects initiated and completed the study; mean age was 43.', 'Thirty participants completed the study (16 females and 14 males; mean age\xa0=\xa053.', '32 subjects (25±13.', 'The study completed 24 women and 11 men.', 'Two hundred adults (103 female and 97 male) aged between 18 and 87 years were evaluated.', 'One hundred and ninety-seven were participated in the study, of which 55% were female with a mean age of 61 years (standard deviation 11).', 'The study was conducted as a randomized double-blind test of 55 subjects in their 50s, including 26 males and 29 females.', 'Our investigation presented a number of associated peculiarities related to gender and age.', 'We enrolled 100 subjects (50 subjects each for NAVA and PSV, 60% male) with a mean ± SD age of 56.', 'A main effect for sex showed that women exhibited 25.', 'Participants had a median age of 71 years (interquartile range 52 to 77 years), and included four women and eight men.', 'Genders were demonstrated accurately for males as 76.', 'Participants were 84 adults: mean age of 72.', 'Fifty participants were studied of whom 20 (40%) were male.', 'Under controlled conditions 6 healthy females (median age 65.', 'This study included 26 elderly woman, who were randomly divided into two sub-groups of 13 participants each.', 'Forty-one subjects (24 males; 62.', 'In a single-group study design, 43 participants (16 male, 27 female; mean age, 19.']


Cluster  619
["First , it is argued that Onora O'Neill has uncovered a serious problem in the way medical ethicists have thought about both respect for autonomy and informed consent .", 'The problem with this avoidance position is that sensitive issues such as sexuality , drug use , and death and dying are laden with spiritual implications , particularly when students are asked to make personal decisions regarding these issues .', 'STN-DBS is not morally neutral and the case involves a tragic dilemma : a conflict between irreconcilable duties for the physician .', '[ A serious medical morality problem ] .', 'In particular , the question of " whose agent ( physician ) are you ? " when a family is in conflict often creates a serious ethical dilemma for the family physician .', 'A serious ethical dilemma .', 'A distressing dilemma the assistant faces is that of distinguishing between the working relationship and the personal friendship .', "A tragic dilemma is an irresolvable dilemma with forced terrible alternatives , where even the virtuous agent inescapably emerges with ; dirty hands ' ."]


Cluster  504
['Multidrug resistance of cancer cells and pathogens is a serious clinical problem .', 'Drug resistance remains a severe problem in most chemotherapy regimes .', 'The acquisition of multidrug resistance poses a serious problem in chemotherapy , and new types of transporters have been actively sought to overcome it .', 'Multidrug resistance ( MDR ) presents a serious problem in cancer chemotherapy .', 'The development of drug resistance and especially of multidrug resistance ( MDR ) is a serious problem during treatment of various malignant tumors .', 'Multidrug resistance , especially multidrug efflux mechanisms that extrude structurally unrelated cytotoxic compounds from the cell by multidrug transporters , is a serious problem and one of the main reasons for the failure of therapeutic treatment of infections by pathogenic microorganisms as well as of cancer cells .', 'Expression of particular drug transporters in response to antibiotic pressure is a critical element in the development of bacterial multidrug resistance , and represents a serious concern for human health .', 'A major problem with treating patients with cancer by traditional chemotherapeutic regimes is that their tumors often develop a multidrug resistant ( MDR ) phenotype and subsequently become insensitive to a range of different chemotoxic drugs .', 'As a drawback of established drugs , like paclitaxel or the vinca alkaloids , the outcome of cancer chemotherapy is often affected by the emergence of the multidrug resistance phenotype .', 'Multidrug resistance ( MDR ) presents a serious problem in cancer chemotherapy .', 'Drug resistance , in particular multidrug resistance , is a serious problem that impedes the effectiveness of chemotherapy .', 'Multidrug resistance ( MDR ) is a serious problem that hampers the success of cancer pharmacotherapy .', 'Multidrug resistance , mediated by the P-glycoprotein 170 transport pump , is a serious problem in multiple myeloma .', 'The development of resistance poses a serious problem in the therapy of cancer due to the necessity of a multiple-drug and unlimited treatment of affected patients .', 'Multidrug resistance ( MDR ) is a severe problem in the treatment of cancer with overexpression of glycoprotein P ( Pgp , ABCB1 ) as a reason for chemotherapy failure .', 'However , multidrug resistance ( MDR ) becomes a severe problem after long-term administration of chemotherapy drugs .']


Cluster  1411
['The aim of this study is to evaluate the effect of excitatory repetitive transcranial magnetic stimulation (rTMS) on recovery of post stroke aphasic patients .', 'Our study showed that the brain lesion regions in post-stroke motor aphasia were not completely consistent with the classical motor speech center.', 'The results of MRI and CT showed diverse brain lesion regions of post-stroke motor aphasia including the cortex, subcortex and cortex together with the subcortex.', 'Twenty patients with post stroke chronic aphasia were enrolled in the study.', 'Excitatory rTMS is a beneficial adjuvant therapy that improves language skills in patients with chronic post-stroke non-fluent aphasia in short and long term.']


Cluster  343
['We found there was no increase in inspiratory work of breathing observed using C-Flex compared to fixed CPAP.', 'No beneficial effects of PA over SA in the subacute phase poststroke were observed, which was comparable for situations of varying complexity.', 'Regurgitations had no impact on supine sleeping position.', 'Double-pass PDL does not enhance PWS clearance.', 'No study has ever compared the efficacy of various types of supraglottic devices (SGDs) for securing the airway under cricoid pressure.', 'Chromametric and visual evaluation suggested that DWL sites showed no significant improvement compared with SWL (p\u2009>\u20090.', 'There was no difference in the rate of proximal DVTs (P=0.', 'None of the used supraglottic airway devices offered a full or partial glottic view in all cases.', 'There were no significant differences in the percentage of irreversibly changed RBCs between the pressures of 0 and 300\u200ammHg.']


Cluster  748
['Non-typhoidal Salmonella ( NTS ) infection is a serious public health problem globally .', 'Since it is estimated that these reported cases only represent 1 to 10 % of the real incidence of this disease , it must be concluded that human salmonellosis is a serious problem all over the world .', 'The results of this study show that multidrug resistance , especially fluoroquinolone resistance , does not represent a serious problem among Salmonella isolates collected from the Latin American medical centers as monitored by the SENTRY Program .', 'Antibiotic resistance in Salmonella enteritidis and S. typhimurium , one of most frequent etiologic pathogens of food-borne bacterial gastroenteritidis in humans , is a serious health problem worldwide .', 'Is salmonellosis still a serious problem in veterinary practice ?', 'Non-typhoidal Salmonella ( NTS ) infection is a serious public health problem globally .', 'The present surveillance data showed a high incidence of salmonellosis in Qatar that poses a serious public health problem .', 'The increase in AmpC-mediated resistance in salmonellae constitutes a serious public health concern , since these enzymes confer resistance to a wide range of beta-lactams .', 'Salmonellosis in Equidae is a serious global problem .', 'Salmonella enterica subspecies enterica infection remains a serious problem in a wide range of animals and in man .', 'Resistance to extended-spectrum β-lactams in Salmonella , in particular , in serotypes such as Salmonella enterica serovar Enteritidis that are frequently associated with clinical infections , is a serious public health concern .', 'Fluoroquinolone resistance is a serious and increasingly common problem in Salmonella .', 'The presence of these virulence genes indicates high pathogenicity potential of these isolates which is a serious public health concern because of zoonotic potential of Salmonella .', 'Salmonella infections are a serious medical and veterinary problem world-wide and cause concern in the food industry .', 'Salmonella infections continue to be a serious problem in modern medicine .', 'Salmonella infection is a distressing health problem worldwide .', 'The proposed research outlines a serious common concern of Salmonella resistance to antimicrobials following prolonged exposure to the disinfectants ( biocides ) .', 'Salmonella carriage in pigs represents a serious health problem that undoubtedly contributes to the spread of human disease .', 'The emergence of ciprofloxacin-resistant Salmonella represents a serious health problem that must be addressed by Libyan health authorities .', 'Salmonella antimicrobial resistance ( AMR ) is a serious concern that can reduce successful treatment of infections , increasing recovery time , medical costs , and mortality rates in humans and animals .', 'Salmonella-infections , the epidemiology and the spread of these germs into the environment are a serious hygienic problem even today .']


Cluster  59
['A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment.', 'Early detailed assessment and symptom management of patients occupying the ambulance bay is extensively undertaken by emergency nurses.', 'Observations were made 8 h/d for 3-5 days in 5 intensive care units (ICUs) (4 hospitals) on a convenience sample of 64 ICU nurses in Texas.', 'Nurses play a crucial role in correctly prioritizing patients entering emergency departments.', 'Patient advocacy is central to the nursing profession yet a sense of certainty about the concept, its meaning and its implications for nursing practice remains elusive', 'Even with full practice authority, nurse practitioners (NPs) face limitations in care and treatment options', "To examine the extent to which the findings from an integrative review regarding perioperative patient advocacy could be empirically supported, and to describe Swedish registered nurse anaesthetists' patient advocacy actions and interactions during the perioperative period.", "On the one hand , this problem can be explained by the population 's lack of awareness for distinguished experts for hand and microsurgery , on the other hand , the emergency network , or emergency doctors in particular are not well informed about where to take a patient with a severe hand trauma - clearly a problem of communication between the hospitals and the ambulance .", 'This study has been performed in undergraduate , graduate , and clinical graduate nursing faculty-suggesting a serious concern in clinical nursing education and clinical practice to meet the complex care needs of the largest , fastest-growing , and costliest U.S. patient population-those with MCCs .', 'A problem with this literature is that a sizable portion of it is unbalanced in its support of nurse influence and in its opposition to hospital bureaucracy .', 'Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics.', 'The initial management of trauma patients by puskesmas nurses has several obstacles that cause delays in the treatment process ; consequently , the safety of patients becomes a serious problem .', "The findings offer a new insight into the registered nurse anaesthetist's professional role.", 'Despite compelling evidence that there was a serious problem with the management of critically ill patients in the ward environment , there is little evidence to support outreach as a concept or as a role for nurse consultants .', '[ Congress of the Swiss Nursing Association in Montreux : if interdisciplinary cooperation is not only a slogan but a serious concern , it demands an honest effort from everyone involved ] .']


Cluster  1461
['However , the generalization that directional verbs with motion-manner adverbials translate as motion-manner verbs with directional adverbials is not expressed or expressible by STAG . the procedure of building such a reference corpus is expensive', 'We have clearly demonstrated that a surprising amount of information about the verb paradigm is strictly local to the verb . the poor generalization power affecting lexical features', 'However , the generalization that directional verbs with motion-manner adverbials translate as motion-manner verbs with directional adverbials is not expressed or expressible by STAG . the procedure of building such a reference corpus is expensive', "In examples 1 , 2 and 3 above ` bought ' is a transitive verb , but without knowledge of traces example 2 in training data will contribute to the probability of ` bought ' being an intransitive verb . a large parameter space", 'When our system takes the verb action , it uses its verb prediction to update the translation using the prediction , by placing it at the end of the source sentence . the parse trees of original and compressed sentences sometimes do not correspond', 'We use Kanzi characters as index terms to retrieve paraphrase candidates , assuming that noun phrases sharing the same Kanzi characters could be paraphrases of each other . it can not infer class information for verbs not listed in Levin', "In examples 1 , 2 and 3 above ` bought ' is a transitive verb , but without knowledge of traces example 2 in training data will contribute to the probability of ` bought ' being an intransitive verb . a large parameter space"]


Cluster  1300
['There was a significant improvement in each group for pain and disability but no difference between the groups.', 'There was no difference between groups for any outcome measures.', 'The analysis revealed no between group differences in musculoskeletal pain in any of the ten body parts.', 'The ITT analysis revealed no differences between groups in healthrelated quality of life on either the emotional or the somatic scale.', 'There was no difference between the groups regarding patient characteristics.', 'There was no difference in demographic data between groups.', 'There were no differences between groups with respect to the MC exam.', 'Demographic data was not different between the groups.']


Cluster  2101
['These could represent a diagnostic problem when offering prevention to couples at risk presenting with unclear phenotypes and might result in a serious fetal problem when the deletion involves embryonic genes .', 'This creates a serious problem in the genetic counseling and diagnosis of MLD .', 'Aneuploidy represents a serious problem for human health .', 'Consanguinity is a serious concern that leads to the high prevalence of recessive disorders in the Middle East and North Africa and possibly other regions .', 'The problem with this new area of cancer genetics is that the identification of gene carriers may become possible , and this raises ethical and social issues .', "Human cytogenetics is a field suffering from the argumentation that it 'is nowadays really outdated and to be replaced by molecular high throughput approaches'"]


Cluster  1091
['Childhood obesity is a serious public health problem today with many potential complications and adverse outcomes for children .', 'Obesity among children is epidemic in the U.S. Although a serious problem because of the rising incidence of Type II diabetes as well as heart disease , it is preventable .', 'Childhood obesity is a serious public health concern .', 'Childhood obesity is becoming a serious problem , and prevention programs are needed .', 'Overweight among 6 - 9-year-old children is a serious public health concern and its variation across the European Region highly depends on the country .', 'Childhood obesity is a serious public health concern worldwide .', 'Due to the high prevalence and adverse consequences, overweight and obesity in children continues to be a major public health concern worldwide', 'Obesity in children is a serious public health problem , and TV viewing is considered a potential risk factor .', 'Pediatric obesity is a serious and prevalent problem .', 'Overweight in children is a serious public health problem .', 'While child and adolescent obesity is a serious public health concern , few studies have utilized parameters based on the causal inference literature to examine the potential impacts of early intervention .', 'Childhood obesity is a serious health concern affecting over 155 million children in developed countries worldwide .', 'Childhood obesity is a serious problem in the UK , with around 20 % of children aged 10 - 11 being overweight or obese .', 'Obesity is a severe health problem in children , afflicting several organ systems including bone .', 'despite the fact that childhood obesity is a serious health problem , little is known about its related factors in early childhood .', 'Childhood obesity represents a social burden.', 'Childhood obesity is a serious and urgent public health problem .', 'Childhood obesity is a serious concern associated with ill health later in life .', 'Pediatric obesity is a serious public health concern .', 'Rising levels of childhood obesity present a serious global public health problem amounting to 7 \xa0 % of GDP in developed countries and affecting 14 \xa0 % of children .', 'Child obesity is becoming a serious public health concern , and major research effort is being devoted both to understand its aetiology and to improve the effectiveness of prevention strategies .', 'Childhood obesity is a serious public health problem because of its strong association with adulthood obesity and the related adverse health consequences .', 'Pediatric obesity is a serious , but clinically neglected , chronic health problem .', 'Childhood obesity has become a severe health problem , especially during the last few decades .', 'Obesity among children has emerged as a serious public health problem .', 'The prevalence of obesity in child population is becoming a serious problem in all advanced countries .', 'Child overweight/obesity continues to be a serious public health problem in high-income countries .', 'Overweight is a serious health problem in children and adolescents .', 'Obesity is a serious problem that affects children from diverse ethnic backgrounds in both industrialised and developing countries .', 'The prevalence of childhood obesity , as with that of adulthood , has increased considerably over the past few years and has become a serious public health problem .', 'Childhood obesity has become a serious public health problem in many low-and-middle income countries .', 'This is a retrospective study including 574 obese children (11.', 'Pediatric obesity is a serious health problem affecting 1 of 6 children in the U.S. A two- to threefold increased incidence is evident in the last two decades .', 'Childhood obesity continues to be a serious public health problem across the globe .', 'The number of children at risk for overweight and the number of overweight children are increasing and have become a serious public health concern .', 'Childhood overweight has become a serious health problem among children and adolescents in the United States .', 'Childhood overweight/obesity is a serious public health concern , and primary care has a role to play in tackling it .', 'Obesity in the pediatric population is a severe public health problem and is associated with various comorbidities .', 'The increasing frequency of childhood obesity is a serious public health concern .', 'Overweight and obesity in children are a serious problem .', 'Childhood obesity has been a serious public health problem .', 'Childhood obesity due to the consumption of excess calories is a severe problem in developed countries .', 'Childhood obesity remains a serious concern in the United States and in many other countries .', 'Lifestyle interventions should include advice regarding sleep improvement with promotion of other healthy lifestyle behaviors to tackle childhood obesity , a serious global public health problem .', "Childhood obesity is a serious public health concern condition , as excess body fat can negatively affect a child 's health ."]


Cluster  2175
['The main problem associated with designing such devices is that of power consumption .', 'However , a drawback of these methods is that a user must be able to recognize and establish contact with the sensor .', "The problem with this approach is that when many devices are trying to respond to the receiver 's transmission invitation and transmit simultaneously , a collision occurs .", 'However , a major drawback of energy harvesting is its varying and intermittent characteristic , which can negatively affect the quality of service .', 'One problem with such devices is that the person may be unable to communicate when the device is not readily accessible .', 'A further drawback of DC electrospinning is that both variants need a collector , which makes it difficult to combine DC electrospinning easily with other technologies due to the presence of the high field strength within the entire spinning zone .']


Cluster  1665
["We sought to measure how a resident's busiest (peak) workload affects their overall productivity for the shift.", 'A cross-sectional observational study was conducted from August 2014 - January 2015 on a sample of 315 shift-work nurses across 39 wards in seven central Italian hospitals.', 'Statistically significantly divergent information was produced by the two data collection methods in the major nursing categories of value-adding care and non-value-adding work as well as in each of the seven nursing subcategories.', "A resident's peak productivity can be a strong predictor of their overall productivity, but the substantial negative effect of variability favors a steadier pace.", 'The study included 20 nursing workers of both genders with an average of 17.', 'A prospective, observational study was conducted during a period of 20 consecutive workdays.', "External observation and self-reporting gave an overall picture of how registered nurses are using their working time, and both methods were useful in examining registered nurses' working time use when taking into account the advantages and disadvantages of these methods.", "To determine the rate of patient moves and the impact on nurses' time.", "Transferring patients is workload intensive on nurses' time and should be included in nursing workload measurement systems."]


Cluster  412
['The clinical setting creates significant anxiety for students that can decrease their ability to learn', 'From August 2017 to November 2017, 100 psychiatric nurses, including 68 females and 32 males, were selected as participants from three hospitals in Hunan Province of China.', 'MBSR therapy can reduce work stress, anxiety, depression, and other negative emotions among psychiatric nurses and improve their mental health.', 'This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.', 'The teaching strategy based on a simulated scenario of a bed bath proved to be effective for the acquisition of cognitive knowledge regarding bed baths in clinical practice and improved student satisfaction with the teaching process.', 'It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses.', 'Traditional mental health clinical experiences expose students to an environment that may not prepare them to address mental health needs in hospital settings.', 'Psychiatrists reporting increased credibility and respect as a benefit of their current age upon their psychiatric practice were older , as were those identifying fatigue and an inability to keep up to date as a drawback of age .', 'This study aimed to evaluate the effectiveness of a simulated bed bath scenario on improving cognitive knowledge, practical performance and satisfaction among nursing students.', 'Negative attitude toward psychiatry ( ATP ) among medical students is a serious concern .']


Cluster  2295
['This is a proven procedure with the drawback of a nonanatomic bile duct drainage by passing the ampullary sphincter system .', 'The incidence of postoperative bile leakage in group B was significantly lower than that in group A (1.', 'This study investigated the impact of Braun anastomosis on the incidence of delayed gastric emptying (DGE) and on the intragastric bile reflux after pancreatoduodenectomy with Child reconstruction.', 'Significant bile leak as an uncommon complication after biliary tract surgery may constitute a serious and difficult management problem .', 'The addition of Braun anastomosis after pancreatoduodenectomy did not effectively reduce the intragastric bile reflux and had minor impact in reducing the incidence of DGE.', 'A drawback of the bile acid dissolution therapy lies in a significant recurrence rate after treatment is discontinued .', 'Hepatic portal reocclusion effectively reduced the incidence of bile leakage compared to the traditional procedure, without significantly affecting liver function.']


Cluster  273
['Hypoxia and high altitudes affect various organs, which impairs important physiological functions, such as a disruption of the intestinal barrier mediated by increased translocation of bacteria and increased circulating endotoxin levels.', 'As a result , hypoxemia-inadequate oxygenation of the blood-is emerging as a serious patient safety problem in noncritical care areas of the hospital .', 'Ambulatory oxygen (O<sub>2</sub>) is the recommended treatment for hypoxemia at rest or induced by exercise.', "We gathered information on subjects' experience traveling with supplementary oxygen and reasons individuals receiving O<sub>2</sub> do not travel.", 'Moderate exercise performed in hypoxia equivalent to 4200 m increased endotoxin plasma concentration after exercise.', 'Arterial hypoxemia is one of the most common respiratory complications following cardiac surgery.', 'The incidence of hypoxemia was not significantly different between the HFNC and standard O<sub>2</sub> groups at 1 h and 24 h after extubation.', 'Maintaining an adequate cerebral oxygen supply is a serious problem in aortic arch surgery .', 'Twenty-nine subjects with liver transplantation who received HFNC after extubation (HFNC group) were matched 1:1 with 29 controls (standard O<sub>2</sub> group) chosen from an historical group of 90 subjects admitted to the ICU during the previous 36 months.', 'The transport of postoperative patients to the postoperative anesthesia care unit (PACU) is a high-risk period for hypoxemia.', 'During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function.', 'After 30 and 60 minutes of prone repositioning, significant decreases in bilateral regional cerebral oxygen saturation were observed compared with the values in the supine position (from 76.']


Cluster  2208
['The IBM Embedded Via Voice -LRB- EVV -RRB- -LRB- Sicconi et al. , 2009 -RRB- -LRB- Beran et al. , 2004 -RRB- ASR engine provides this functionality and is used in this system . the time required to load and watch the videos', 'The IBM Embedded Via Voice -LRB- EVV -RRB- -LRB- Sicconi et al. , 2009 -RRB- -LRB- Beran et al. , 2004 -RRB- ASR engine provides this functionality and is used in this system . the time required to load and watch the videos', 'The IBM Embedded Via Voice -LRB- EVV -RRB- -LRB- Sicconi et al. , 2009 -RRB- -LRB- Beran et al. , 2004 -RRB- ASR engine provides this functionality and is used in this system . the time required to load and watch the videos']


Cluster  1577
['Caring for patients is a source of significant emotional distress.', 'Psychological and emotional impairment among physicians represents a serious , widespread , and difficult problem .', 'We found that practitioners experienced significant emotional distress.', 'Research has provided an abundance of data on moral distress with limited research to resolve and help negate the detrimental effects of moral distress', 'Psychological distress is a serious problem faced by many of the people whom nurses encounter on a daily basis .', 'Moral distress is thought to be a serious problem among nurses , particularly those who practice in critical care .']


Cluster  605
['By RNA sequencing, we examined whether the stratum corneum transcriptome in AD skin can be assessed by tape stripping, as compared to the epidermal transcriptome of AD in skin biopsies.', 'However , currently , the difficulty of isolating high-quality RNAs from plant tissues bearing abundant complex polysaccharides , polyphenolics , and secondary metabolites is a serious problem that not only limits the application of these technologies but also hinders studies dealing with RNA', 'Abnormal and rapid proliferation of colon cancer cells is a severe problem that can be regulated by non-coding RNAs .', 'A major drawback of the use of such a transcriptional reporter-based assay in a library screen is the frequent occurrence of false-positive results due to bait RNA-independent activation of the reporter gene .', 'A drawback of conventional RT-PCR from full-thickness specimens is that gene expression analysis is based on heterogeneously composed tissues .', 'A second problem with measurements of biallelic IGF2 transcription is that the co-amplification of contaminating genomic DNA during the RT-PCR step can lead to an overestimation of the frequency of biallelic IGF2 expression .', 'Shotgun sequencing could be performed on skin cells obtained from two consecutive tape strips which had been stored and shipped at room temperature for up to three days.', 'One limitation with the initial experiments was that the RNAs were isolated from heterogenous cell populations and it was impossible to distinguish whether all of the cells were producing the abundant mRNAs or if a subset of the cell population was responsible for the majority of the RNA species .', 'An inherent problem with this approach is that the presence of specific cell surface markers does not directly reflect the transcriptional state of a cell .', 'A major problem with this approach , however is that it results in considerable DNA degradation , and large quantities of genomic DNA material are needed if numerous genomic regions are to be profiled .']


Cluster  1076
['Obesity is a serious health problem worldwide associated with an increased risk of life-threatening diseases such as type 2 diabetes , atherosclerosis , and certain types of cancer .', 'Obesity is a serious health problem implicated in many metabolic disorders ( i.e. , hypertension , dyslipidemia , and cardiovascular disease ) .', 'Obesity has become a serious health problem worldwide because it is closely related to the leading causes of morbidity and mortality , including diabetes mellitus , hypertension , atherosclerosis , and dyslipidemia .', 'Obesity is a serious health concern and is associated with a reduced quality of life and a number of chronic diseases , including diabetes , heart disease , stroke , and cancer .', 'Obesity is a serious health problem for all age groups and it also promotes Type 2 diabetes , cardiovascular diseases , cancer and hypertension .', 'Obesity is a serious health problem associated with the pathogenesis of various metabolic diseases .', 'Obesity is a serious epidemic health problem that can cause many other diseases including type 2 diabetes and cardiovascular diseases .', 'Obesity is a serious health problem and a major risk factor for the onset of several diseases such as heart disease , diabetes , stroke and cancer .', 'Obesity has become a serious public health problem and a major risk factor for the development of illnesses , such as insulin resistance and hypertension .', 'Obesity is a global epidemic that poses a serious health concern due to it being a risk factor for life-threatening chronic diseases , such as type 2 diabetes , cancer , and cardiovascular diseases .', 'Obesity poses a serious problem to human population as it increases the risk of diabetes , hypertension , metabolic syndrome .', 'Obesity is a serious health problem that is implicated in many metabolic disorders .', 'Obesity is a serious public health problem associated with predisposition to develop metabolic diseases .', 'An increasing epidemic of obesity has become a serious public health concern primarily because it contributes to pathogenesis of many chronic diseases including type 2 diabetes , cardiovascular disease , hepatobiliary disease , obstructive sleep apnea , kidney disease , some types of cancer , among others .', 'Obesity is a serious , worldwide and growing problem , with associated complications ranging from cardiovascular disease to cancer .', 'Obesity has become a serious problem in public health worldwide , causing numerous metabolic diseases .', 'Obesity is a serious health problem with an increased risk of several common diseases including diabetes , cardiovascular disease , and cancer .', 'Obesity causes metabolic disease and is a serious health problem around the world .', 'Obesity causes metabolic disease and is a serious health problem around the world .', 'Obesity is a serious concern because it has been the leading causes of death worldwide , including diabetes , stroke , heart disease and cancer .', 'Obesity is a major risk factor for the development of illnesses , such as insulin resistance and hypertension , and has become a serious public health problem .', 'Obesity is a severe health problem worldwide , which leads to multiple comorbidities including type 2 diabetes mellitus and cardiovascular diseases .', 'Obesity ( defined as body mass index ( BMI ) higher than 30 ) , is a serious and global public health problem , associated with increased morbidity and mortality and it represents a risk factor for developing various somatic and psychiatric disorders .', 'Obesity has become a serious public health problem and a major risk factor for the development of illnesses , such as insulin resistance and hypertension .', 'Nowadays , obesity becomes a serious global problem , which can induce a series of diseases such as type 2 diabetes mellitus , cancer , cardiovascular disease , metabolic syndrome , and stoke .']


Cluster  1335
['Over the last few decades , scientific interest in food-derived bioactive peptides has grown as an alternative to pharmacological treatments in the control of lifestyle-associated diseases , which represent a serious health problem worldwide .', 'This relatively small 37-amino acid peptide constitutes a serious scientific , research and to some extent a medical problem .', 'This relatively small , 37-amino acid peptide constitutes a serious scientific , research and to some extent a medical problem .', 'A major drawback of therapeutic peptides is their short half-life , which results in the need for multiple applications and high synthesis costs .', 'A drawback of this approach , however , is that once synthesis of the peptide is complete , regeneration of the thioamide requires the toxic , corrosive , and flammable gas H']


Cluster  659
['Recently , epidemic outbreaks of EV71 with significant mortality have been reported in the Asia-Pacific region , and EV71 infection has become a serious public health concern worldwide .', 'The prevalence of diseases caused by EV71 infection has become a serious public health problem in the Western Pacific region .', 'Detection of the high rate of prevalence of ET genes in the current study is considered as a serious problem because it is likely to spread and transfer these genes between strains .', 'Many children and infants have died from serious neurological complications during these epidemics , and EV71 infection has become a serious public health problem in these areas .', 'However , the appearance of these enzymes on plasmids in Japan poses a worrisome problem .', 'The worldwide dissemination of 16S-RMTases is becoming a serious global concern and this implies the necessity to continue investigations on the trend of 16S-RMTases to restrict their further worldwide dissemination .', 'In all , A. baumannii with all the 16S rRNA methylase , modifying enzyme , and ESBL genes is extremely prevalent in northeastern Sichuan , China , posing a serious clinical concern with a major therapeutic threat in the future .', 'The progressive increase in prevalence of the highly virulent EM populations is a serious concern because of their symptom severity , and the presence of multiple EM variants that include recombinants necessitates new efforts to develop durable control strategies .', 'Acquisition of an additional plasmid harbouring ESBL genes is a step towards increasing the risk of O80 EHEC dissemination and represents a serious public health concern .', 'We showed that the detection of a specific gene combination could assist in identifying non-O157 VTEC isolates that pose a serious public health concern .']


Cluster  1217
["Although schistosomiasis remains a serious health problem worldwide , significant achievements in schistosomiasis control has been made in the People 's Republic of China .", "Manson 's schistosomiasis continues to be a severe public health problem in Brazil , where thousands of people live under the risk of contracting this parasitosis .", 'Urogenital schistosomiasis due to Schistosoma haematobium is a serious underestimated public health problem affecting 112 million people - particularly in sub-Saharan Africa .', 'Schistosomiasis is a severe public health problem , which can cause tissue fibrosis and can even be fatal .', 'Schistosomiasis , caused mainly by S. mansoni , S. haematobium and S. japonicum , continues to be a serious tropical disease and public health problem resulting in an unacceptably high level of morbidity in countries where it is endemic .', 'Schistosomiasis is a severe public health problem in China .', 'Schistosomiasis remains a serious public health problem in affected countries , and routine , highly sensitive and cost-effective diagnostic methods are lacking .', 'Schistosome parasites still represent a serious public health concern and a major economic problem in developing countries .', 'Schistosomiasis caused by schsitosomes is a serious global public health concern .', 'Schistosomiasis remains a serious public health problem with 200 million people infected and 779 million people at risk worldwide .', 'Schistosomiasis is a serious public health problem , prevalent in tropical and subtropical areas , especially in poor communities without access to safe drinking water and adequate sanitation .', 'Schistosomiasis caused by Schistosoma spp . is a serious public health concern , especially in sub-Saharan Africa .', 'In spite of numerous efforts towards the control of its transmission , schistosomiasis still remains an important parasitic disease and represents a serious public health concern and a major economical problem in a lot of developing countries .', 'Schistosomiasis affects more than 200 million individuals worldwide , with a further 650 million living at risk of infection , constituting a severe health problem in developing countries .', 'Schistosomiasis is one of the most important parasitic diseases present in developing countries configuring it as a serious public health problem , directly related to poverty and social disadvantage .', 'Schistosomiasis is a serious health problem especially in developing countries and affects more than 243 million people .', 'Schistosomiasis remains a serious health problem in Africa .', 'Schistosomiasis , caused by parasitic trematodes of the genus Schistosoma , remains a devastating public health problem , with over 200 million people infected and 779 million people at risk worldwide , especially in developing countries .', 'Urinary schistosomosis is a serious public health problem prevalent in low-income rural regions of sub-Saharan Africa , including coastal part of Kenya .', 'Schistosomiasis remains a serious public health concern in China .', 'Schistosomiasis is a serious public health problem in Brazil and worldwide .', 'Schistosomiasis remains a serious public health problem , with 200 million people infected and 779 million people at risk worldwide .', 'Worldwide schistosomiasis continues to be a serious public health problem .', 'Schistosomiasis remains a severe problem of public health in developing countries .', 'Despite the success of control programmes , schistosomiasis is still a serious public health problem in the world .', 'The inherent morbidity and mortality caused by schistosomiasis is a serious public health problem in developing countries .', 'Worldwide Schistosomiasis mansoni continues to be a serious public health problem .', 'Schistosomiasis japonica , caused by Schistosoma japonicum , is still a serious public health problem in China .', 'Schistosomiasis is considered a serious public health problem in 78 countries and territories located in Africa , Asia and America and it is estimated in more than 249 million people infected by any of the species of Schistosoma .', 'Such savings might encourage more frequent measurements in regions where schistosomiasis is a serious but neglected problem .', 'As a complement to chemotherapy and other control approaches , the development of an effective vaccine is necessary to combat Schistosomiasis japonica that remains a serious public health problem in China .', 'Schistosomiasis , one of the most prevalent neglected tropical diseases , is a life-threatening public health problem in Yemen especially in rural communities .', 'Schistosoma japonicum is one of the three major blood fluke species , the etiological agents of schistosomiasis which remains a serious public health problem with an estimated 200 million people infected in 76 countries .']


Cluster  207
['DAA therapy in LT patients was effective and safe in this single-center real-life cohort.', 'Patients receiving the CBEA intervention experienced a greater reduction in pain as compared to those receiving the usual care at the end as well as 4 and 12 weeks after the intervention (P< 0.', 'A careful baseline evaluation and a strict monitoring allow to optimise management and outcome of DAAs in elderly.', 'DN and CS injection afforded significant improvements during the 6 months of follow-up.', 'Excellent clinical results for both DAA and ALA were achieved.', 'It showed that both LT and ACT groups were able to be effective and reduce DA in comparison with the control group and such a positive effect on the improvement of DA was evident both in the post-test and follow-up stages.', 'To assess early treatment experience with DCA injection in a clinical practice setting.', 'The impact of the DA will be evaluated in a randomized controlled trial with a two-week follow-up.', 'In this single-center, prospective, single-arm, observational study, 100 consecutive patients seeking to decrease submental fullness received subcutaneous DCA (2 mg/cm) injections in the submental area (maximum of 6 sessions at ≥1 month intervals).', 'Deoxycholic acid (DCA) is approved for improvement in the appearance of moderate to severe convexity or fullness associated with submental fat.']


Cluster  1199
['This study aimed to investigate effects of Basic body awareness therapy (BBAT) on curve magnitude, trunk asymmetry, cosmetic deformity, and quality of life in adolescent idiopathic scoliosis (AIS) patients.', 'Scoliosis is a serious clinical problem which requires a systematic physical therapy and control of body balance - treatment from the moment of achieving skeletal maturity by a child .', 'This study shows that the NST may be a beneficial option to correct spinal alignments in patients with adolescent idiopathic scoliosis.', "We aimed to investigate the long-term effect of a neuromuscular stabilization technique (NST) on Cobb's angle in patients with adolescent idiopathic scoliosis.", 'In scoliosis, curve progresses due to muscle imbalance and poor posture.']


Cluster  148
['Drinking 500mL of water or isotonic drink close to phlebotomy is useful in preventing presyncopal or syncopal reactions in blood donors.', 'The plasma catalase levels preoperatively and following surgery in the LC and MC patients versus those with cancer were quite similar.', 'Following post-surgical parenteral nutrition, the levels of ALB, PAB and Hb were significantly higher in the study group than those in the control group.', 'During this retrospective study, computerized medical charts (N\xa0=\xa0735) from 2007-2010 were reviewed for electrolyte changes (particularly potassium, magnesium, and phosphorus) the first 3 days following PN initiation in hospitalized adults.', 'Serum lactate and BE may be used as prognostic markers to predict mortality in patients undergoing TOF repair.', 'For the atorvastatin group, we found posttreatment reductions of Lp-PLA2 activity (p<0.', 'To compare the RGV and pH of patients fasted for 6-12 h with those allowed oral intake of fluid up to 2 h preoperatively.', 'The median plasma catalase levels preoperatively and following surgery in the LC and MC patients versus those with cancer did not differ statistically significantly.', 'Body compositions and nutritional indicators in blood tests were measured at the baseline and at the 1st, 3rd, 6th, and 12th postoperative months (POM).', 'Amylase began to rise during initial extracorporeal circulation and reached a maximum level postoperatively at 6 and 24hours.', 'Our results showed that the patients who died within 30days of admission and those who did not had comparable PLR and lactate levels (p=0.']


Cluster  784
['The mean inhaled gas temperature and absolute humidity were higher in the HME (29.', 'Analyses show a significant improvement of olfactory function for participants in the OT group and improved verbal function and subjective well-being.', 'Loss of olfactory function is largely found with aging.', 'Endtidal levels of carbon dioxide were considerably lower in all sample sets and only 4/23 individual ET-blood gas sample pairs differed <7.', 'The results suggest that EANx could protect against decreased neuro-cognitive performance induced by inert gas narcosis.', 'Identification of the breathing gas was not possible on subjective assessment alone, while cognitive assessments showed significantly better performance while breathing EANx.']


Cluster  68
['The major problem with the use of a rating scale was that , as a one off scoring system , it did not reflect the dynamic nature of suicidal behaviour .', 'This leads us to the central problem with health measurement , which is that we can not currently be sure what most rating scales are measuring .', 'One problem with the current structure is that it defines conditions that complicate pregnancy and perinatal conditions on the same hierarchical level as organ system diseases .', 'Thus , the major problem with defining an MCID for any measure is that the most important differences , which require the most subtle measures for an individual patient , are likely to have the least general application .', 'A drawback of existing tools is their focus on identifying single factors associated with the observed or measured ranks , failing to address relationships between these factors .', 'One problem with this multidimensionality , however , is that no explicit criteria have been offered for applying this concept to an evaluation of research .', 'The problem with clinical definitions is that the decision is inevitably subjective , and the process is too cumbersome .', 'An important limitation of studies with higher relapse rates is that no attempt has been made to identify patients with mild or severe disease .', 'A fundamental problem with the Z-score , however , is that direct and indirect regulations can not be easily distinguished .', 'Setting uniform ACBGL cutoffs for NH definition is unachievable due to the enormous heterogeneity among newborns.', 'The problem with this standard method is that we do not have any generally accepted criteria for determining a proper threshold .', 'A major problem with previous terminology was that it did not allow for identification of pathophysiological interactions occurring in the different types of combined heart/kidney disorders .', 'The nonrandom selection of patients into groups, the small sample size, and the inability to adjust risk for unknown factors (eg, medical diagnoses, comorbidities, funding, and functional measures) limited interpretation of the results.', 'Lack of robust quality-of-life-data is also a serious shortcoming in the decision process for this patient category .', 'RIs based on adult criteria are not applicable to adolescents.', 'A potential limitation with the study is that the MNA was used as gold standard among patients younger than 65 years .', 'A major problem with using current findings on well-being to guide policy is that they derive from diverse and incommensurable measures of different concepts , in a haphazard mix of respondents .', 'A current limitation with these approaches is that they require each rater to generate a complete dataset , which is often impossible given both human foibles and the typical turnover rate of raters in a research or clinical environment .', 'The problem we face with determining the factors that increase the risk of disabling disease is that there is no standardized and consistent definition of disabling or aggressive disease .']


Cluster  218
['To assess the problem, we conducted an observational retrospective study in the aircrew population examined in 2014 at the Aeromedical Center of Percy Military Hospital.', 'In a randomized controlled study design, 21 volunteer military pilots from the Norwegian and Swedish Air Force were asked to perform tracking and chart-reading tests.', 'Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design).', 'A retrospective observational study was conducted on helicopter air ambulance cases recorded between January 2003 and December 2016 at Wakayama Medical University Hospital (WMUH).', 'Fear of flying ( FOF ) can be a serious problem for individuals who develop this condition and for military and civilian organizations that operate aircraft .', 'The helicopter air ambulance is an important form of medical transportation in the south Kii peninsula.', 'Due to their working conditions, airmen are exposed to a real infectious risk, which is, however, difficult to evaluate.', 'An observational study combined with subjective questionnaires were carried out during a bioterror simulation drill.']


Cluster  47
['Vaccine refusal is a serious public health problem , especially in the context of diseases with potential to spark global pandemics , such as Ebola virus disease in the Democratic Republic of the Congo .', 'Reduction in routine immunization coverage may represent a serious life-threating problem for unvaccinated or under-vaccinated children .', 'Vaccination against MDC in Brazil had a positive impact on the population of children aged < 1 year, across all regions, and on the 1-4 year-old cohort.', 'The movements of the opponents of vaccination appear to be more effective than the planned education of doctors and their patients , and the absence of sufficient administrative control performance of vaccination , raises a serious problem in contemporary clinical researcher .', 'Tetanus remains a serious problem in public health , particularly in developing countries , despite efficient prevention programs .', 'In the short term, a measles vaccination campaign seems not to increase nonaccidental outpatient consultations but may reduce them.', 'Diphtheria is still a preventable public health problem in many developing countries .', 'Pertussis remains a serious problem in many countries .', 'The study objective was to evaluate the impact of this vaccination strategy.', "In a cluster-randomized trial assessing a measles vaccination campaign's effect on all-cause mortality and hospital admission among children aged 9-59 months in Guinea-Bissau, children received a measles vaccination (intervention) or a health check-up (control).", 'Measles is still a serious problem in our country for undernourished infants and our try suggests that cimetidine can be used in this viral disease to shorten the course .', 'Bordetella pertussis infection is endemic and continues to be a serious problem among unvaccinated or incompletely vaccinated infants .', 'It represents a serious public health concern and vaccination constitutes an important tool to reduce or at least mitigate its burden .', 'During the past few years , vaccine shortage has been a serious problem affecting both developed and developing countries .', 'FS occurrence in children is a serious concern because it leads to public apprehension of vaccinations .', 'Non-neonatal tetanus remains a serious public health problem , although neonatal tetanus has been eliminated in China since 2012 .']


Cluster  1498
['The development of infections with ganciclovir (GCV)-resistant human cytomegalovirus ( HCMV ) remains a serious problem in recipients of stem cell or organ transplants .', 'Cytomegalovirus retinitis remains a serious problem in AIDS patients , and the species specificity of human cytomegalovirus ( HCMV ) has hindered the development of animal models suitable for testing new therapeutic agents .', 'Congenital cytomegalovirus ( CMV ) infection is a serious health problem .', 'Although human cytomegalovirus ( HCMV ) rarely causes overt disease in healthy individuals , the virus can be a serious , even life-threatening problem in immunosuppressed or immune-deficient patients and in the setting of maternofetal primary infection .', 'In transplant recipients , drug-resistant human cytomegalovirus ( HCMV ) infections remain a serious problem .', 'The antiviral resistance of cytomegalovirus ( CMV ) infections is associated with mutations in the CMV UL54 and UL97 gene regions and is a serious problem in immunocompromised patients .', 'Human cytomegalovirus ( HCMV ) poses a serious public health problem causing morbidity and mortality in transplant recipients , immunocompromised patients , and congenitally infected newborns .', 'Cytomegalovirus ( CMV ) infection remains a serious problem in lung transplant recipients .']


Cluster  163
['One hundred cases of unilateral upper urinary tract calculi with stent insertion (pre and post flexible ureteroscopy) were randomized into 4 groups, given non-treatment, solifenacin, tamsulosin or combination respectively.', 'This trial will provide level Ib evidence about the differences in both surgical and functional outcome between vsAR and tAR, which may importantly scape the future of bulbar urethral reconstruction.', 'The skeletal pain control is a serious problem and it is a great responsibility also for the Urologists especially if the patient has not a short survival time and the quality of life is very poor .', 'The novel method of contact ureterolithotripsy is a safe and promising alternative to the conventional contact ureterolithotripsy in a fluid medium in a carefully selected patient population.', 'The treatment of the strictures in the posterior urethra and especially in its bulbar part is a serious therapeutic problem .', 'There have been a troublesome problem to treat with obliterative urethral strictures , the challenge is how to reduce wound of surgery and improve therapeutic success rates .', 'The treatment of the congenital and acquired diseases of the male urethra is a serious health and social problem .', '99 patients from eight centers with heterogenous urethroplasty experience levels were included in this prospective, non-interventional observational study.', 'This study presents short-term outcomes related to changes in existing and de novo lower urinary tract symptoms (LUTS), pelvic pain, and bowel function following robot-assisted laparoscopic uterosacral ligament suspension (RALUSLS) and sacrocolpopexy (RALSC).', 'Ureteral stent retrieval using rigid ureteroscope under topical anesthesia is as safe and effective as flexible cystoscope but with a much lower cost to patients.', 'Transurethral and/or percutaneous combined endo-urological approaches are usually sufficient for the removal of forgotten double-J stents.']


Cluster  697
['A major drawback of the IgG capture step is the high cost of the protein A resin .', 'However , a general drawback of this method is the high background due to persistence of the parent template resulting in low efficiency of mutagenesis .', 'However , a major drawback of ISH is the fact that all standard protocols available include time consuming optimization steps of several critical parameters such as tissue fixation , hybridization conditions and washing procedures .', 'For the TEA/HFIP system , however , such adducting represents a severe problem particularly if large oligonucleotides are analyzed .', 'However , the treatment has a severe problem of leukemogenesis caused by insertional mutagenesis ; therefore , it is not applicable for diseases caused by the gain-of-function of mutated genes .', 'However , the low efficiency of transformation achieved by DNA transfection is a major drawback of the system .']


Cluster  161
['As a result , we employ it as one metric for measuring the similarity of two DRDAs . it exclusively focuses on error types taken in isolation', 'The higher the d-value , the more of the simplified and unsimplified pairs are lumped together as indistinguishable . depending on relations from hand-built training data , knowledge bases or ontologies', 'The d-ROM values for CAS were 355±58.', 'The t statistic of the difference between each test instance pair is computed , giving rise to a p value . the system currently only works for Wikipedia pages', 'The best scheme, which comprised a projection through Linear Discriminant Analysis (LDA) and k-means clustering, was evaluated in leave-one-subject-out cross-validation; notably outperforming the standard industry procedures for PA intensity classification: score 84.', 'According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.', 'The determination of the bioequivalence of HVDs has been a vexing problem since the inception of the current regulations .', 'NPMP, APACHE\xa0II, SAPS\xa0II, MPM<sub>72</sub>\xa0II, SOFA, and VAP-PIRO were found to have similar and acceptable discrimination power as assessed by the area under the ROC curve.', 'DARs are more common than IAR and are of different profile.', 'We propose a scoring system including FCL to distinguish PAF from non-PAF.']


Cluster  1732
['A total of 176 patients were included in the final analysis (control 91, intervention 85).', 'A total of 117 patients participated in the study.', 'The study included 254 patients, with 127\xa0patients in each group.', '185 patients were randomized during the study period and 143 patients were included in the final analysis.', 'Overall, 140 patients from two European centers were included.', 'Of 120 randomized patients, 108 were included in the final analysis.', 'A total of 272 patients were included in the study.', 'In total, 141 patients were investigated.', 'In total, 133/161 patients completed the study.', 'A total of 226 participants entered the study.', 'The study was completed by 146 patients.', '139 patients were recruited.', 'A total of 152 patients were randomized, and 141 were included in the analysis.', 'Of the 112 participants randomised, 101 completed the study.', 'A sample of 190 patients was evaluated after the treatment; 121 were responders.', 'The final study population included 145 patients.', 'A total of 117 patients completed the study.', 'Of 244 eligible patients, data of 206 patients who completed the study were analyzed.', 'A total of 123 patients chose to participate in one of the interventions.']


Cluster  166
['The main problem with this approach is that the Cu plate/phosphor screen must be thin ( approximately 2 mm thick ) in order to obtain a high spatial resolution , resulting in a low x-ray absorption or low quantum efficiency for megavoltage x rays ( typically 2 - 4 % ) .', 'A practical problem with the design is that extremely discordant pairs that are ostensibly full sibs may be half sibs .', 'However , a serious drawback of these SRMs is that they are certified only in the backscattering ( 180 ° ) configuration .', 'However , a drawback of this approach is that a very large number of particles are needed to achieve accurate results in real environments .', 'A problem associated with SNOM is that the light throughput decreases markedly as the aperture diameter decreases .', 'But , inelastic scattering is a serious problem .', 'But this method poses a serious problem of beta self-attenuation in the foils .', 'However , it has a drawback of limited field of view ( FOV ) , because of the axial extension of the X-ray emission area .', 'A major drawback of the method is that it operates on the scattered field , which can not generally be directly measured , but must instead be calculated by subtracting the incident field , i.e. \xa0 the equivalent field with no scatterer present .', 'A drawback of these devices is that the majority of the resonant electromagnetic energy is confined within the solid light-guiding structure thus limiting the degree to which it overlaps with the bound matter .', 'However , a major drawback of this approach is the high radiation intensity required to achieve the necessary force to trap a particle which can damage biological samples .', 'Nevertheless , this approach has not led to wide use of these aberration correctors , partly because aberrations of the bending magnet can be a serious problem .', 'The main problem with these measurements is that coincidence effects are large for close source-detector geometries .', 'The large dispersive line of this unwanted center signal would be a fatal problem in the case of detecting small (LR)J(CC ) couplings .', 'However , a major drawback of wide field imaging is the very limited imaging depth in scattering samples .', 'However , they suffer from a serious sweep jamming problem , which significantly reduces the ranging performance .', 'Besides this advantage , a drawback of such a system is additional x-ray scatter originating from the extra ( cross-illuminating ) cone beam .', 'A drawback of the detector is its low , spatially varying energy resolution .']


Cluster  1845
['Chronic hepatitis C virus ( HCV ) infection is a serious public health problem worldwide .', 'Infections with Hepatitis C virus ( HCV ) pose a serious health problem worldwide .', 'Hepatitis C virus ( HCV ) is a serious global health problem affecting approximately 130 - 150 million individuals .', 'Hepatitis C virus ( HCV ) is a serious global health problem which accounts for approximately 40 % of chronic liver diseases worldwide .', 'With over 170 million individuals chronically infected with hepatitis C virus ( HCV ) worldwide , HCV is currently a serious global health concern , leading to chronic hepatitis , cirrhosis and HCC , thereby causing significant morbidity and mortality .', 'Hepatitis C virus ( HCV ) remains a serious global health problem that lacks an effective cure .', 'Hepatitis C virus ( HCV ) infection is a serious public health problem throughout the world .', 'Infections by HCV represent a serious global health problem , because millions of people worldwide are infected and no efficient treatment is available at the present time .', 'Hepatitis C virus ( HCV ) infection is a serious global health problem .', 'Hepatitis C virus ( HCV ) infections are a serious global-scaled public health problem .', 'The hepatitis C is a severe public health problem worldwide because its consequences .', 'Hepatitis C virus ( HCV ) infection has become a severe health problem worldwide .', 'Hepatitis C virus ( HCV ) infection is a serious public health problem .', 'HCV virus infections have become a serious epidemiological problem throughout the world .', "Hepatitis C Virus ( HCV ) is a serious global health problem , infecting almost 3 % of the world 's population .", 'Hepatitis C virus ( HCV ) represents a serious worldwide healthcare problem .', 'HCV ( hepatitis C virus ) infection is a serious health care problem that affects more than 170 million people worldwide .', 'The hepatitis C virus ( HCV ) is globally recognized as a serious public health concern .', 'Hepatitis C virus ( HCV ) infection remains a serious health problem worldwide .', 'Infection with hepatitis C virus ( HCV ) is a serious public health problem worldwide .', 'Hepatitis C virus ( HCV ) infection is a serious public health problem , that affects approximately 170 million people worldwide .', 'Infection by hepatitis C viruses ( HCVs ) is a serious medical problem with no broadly effective treatment available for the progression of chronic hepatitis .', 'Hepatitis C virus ( HCV ) infection represents a serious health-care problem .', 'Hepatitis C virus ( HCV ) infection represents a serious health problem .', 'Hepatitis C virus ( HCV ) , the major etiological agent of transfusion-associated non-A , non-B hepatitis , is a severe health problem affecting up to 3 % of the world population .']


Cluster  835
['Since each parallel corpus is independently aligned , the number of sentences in each bitext is not the same across the language pairs . the availability of annotated corpora , which do not exist for all languages', 'We also include several baselines that have access to the same training data as our system . not being able to take into account the influence of a wider linguistic environment', 'Manuscripts must be written in English . exponential explosion of unpacked parse results', 'For example , different NLG systems may require very different domain-dependent language resources , or make different assumptions on which resources are domain-dependent or independent . they aggregate scores of different pairs — even though these scores can vary greatly in the embedding space', 'Since each parallel corpus is independently aligned , the number of sentences in each bitext is not the same across the language pairs . the availability of annotated corpora , which do not exist for all languages', "We expect that in future the IndoWordNet API 's will be used for the development of tools and software resources by IndoWordNet members . combinatorial explosion in parsing English", 'With conventional Japanese parsers , the linguist must classify the . bunsetsu and select appropriate features to compute modification values . being carried out on small corpora', 'Many hand-tested corpus evaluations have been done in the past ( e.g. , Walker 1989 ; Strube 1998 ; Mitkov 1998 ; Strube and Hahn 1999 ) , but these have the drawback of being carried out on small corpora', 'The major limitation of these works is the use of EUROVOC , which is a specific resource workable only for European languages', 'The theme of the workshop will be Machine Translation which is currently very topical given the newly-achieved official European status that the local language now enjoys . the very small size of its syntax , lexis , semantics and working domain', 'This paper describes the resulting lexicon , CzEngVallex , and the process of building it , as well some interesting observations and statistics already obtained . pervasive structural divergence between languages', 'The syntax based statistical approaches have been faced with the major problem of pervasive structural divergence between languages', 'FrameNet provides semantic roles as character offsets . they are ad-hoc : the rules that govern word formation and inflection are only implicit in such systems , usually intertwined with control structures and general code']


Cluster  459
["The quality of patient-provider interactions, perceived treatment effects, and information sharing influenced BRLP patients' satisfaction with care.", 'Patients were randomly assigned to groups to complete the validated Consumer Assessment of Healthcare Providers and Systems (CAHPS) clinician and group patient satisfaction survey using a Web-based platform.', 'Spine surgeons are more likely to receive favorable reviews for factors pertaining to outcomes, likeability/character, and negative reviews based on ancillary staff interactions, billing, and office environment.', 'Semi-structured interviews were conducted with 52 cardiothoracic surgeons, anaesthetists, nurses and physiotherapists in three public tertiary referral hospitals and three private hospitals in New South Wales (NSW).', "Using patients' recall of their preoperative status may lead to overestimation of the effectiveness of surgery, particularly for lumbar spine surgery.", 'Patients visit their PCP for a wide variety of reasons, often during the same visit.', 'Cardiac surgeons were surveyed to assess their evaluation of the current feedback reports and assist in developing the content of structured feedback.', "To describe patient's reasons for visits to primary care physicians (PCPs) as presented by the patient; and to examine the effect of patient-, doctor- and clinic-related variables on the reasons for the visit."]


Cluster  281
['Water pollution caused by organic wastewater has become a serious concern worldwide .', 'Pollution of water by sewage and run-off from farms produces a serious public health problem in many countries .', 'Water pollution is a serious environmental problem .', 'Water pollution from the release of industrial wastewater is a serious problem for almost every industry .', 'Pollutants from industrial sites and from municipal sewage treatment works ( STW ) entered the Elbe and led to a serious pollution problem in the river .', 'Urban pollution of riverine ecosystem is a serious concern in the Niger Delta region of Nigeria .', 'Water pollution is a serious problem in modern society .', "Pollution of Florida 's waterways is a serious problem .", 'There is a serious problem of water pollution in central Dhaka , in the Turag-Tongi-Balu River system in Bangladesh with the river system being one of the most polluted in the world at the moment .', 'Groundwater pollution from agricultural practices is a serious environmental and health problem .', 'Wastewater discharges into freshwater bodies represent a serious ecological problem worldwide .', 'Pollution in the delta is increasingly recognized as a serious health concern that requires proper management of ecosystems .', 'Large nutrient losses to groundwater and surface waters are a major drawback of the highly productive agricultural sector in The Netherlands .', 'Depending on the use and management , wastewater generation can be a severe environmental dilemma or a potential source .', 'Based on these last two indexes , San Jorge Bay has a serious problem of Cu and Pb pollution at the three sampling locations .', 'Water pollution is a serious environmental problem affecting millions of people , and the demand for frequent water quality monitoring is increasing .']


Cluster  124
['Experiments using all data are also reported , although a 64GB machine was necessary , even with binarized phrase and distortion tables . the limited input features', 'In experiments not reported here , we found that taking into account the brevity penalty at the sentence level can cause large fluctuations in lattice MBR performance on different test sets . we would have to set up too many of them depending on the various shapes and functions of bent trajectories', 'We furthermore report on an experiment that tests predictions that follow from simulations . it willperform slower as it needs to process all the words', 'We furthermore report on an experiment that tests predictions that follow from simulations . it willperform slower as it needs to process all the words', 'Before identifying all possible noun phrases for testing , the search space of all documents in a large text database will have to be efficiently narrowed down first . the n-gram simulations only use a window of n moves in the dialogue history', 'Our results suggest that on the shared task , a combination of features relying only on word and character ngrams provided a strong baseline . exact inference is intractable for those dynamically generated segment level features', 'In a projected space with approximately 103 or 104 fragments , including a few hundred more features can produce noticeably different accuracy readings . the fact that misspellings resulting in real words were not addressed', 'Before identifying all possible noun phrases for testing , the search space of all documents in a large text database will have to be efficiently narrowed down first . the n-gram simulations only use a window of n moves in the dialogue history', 'In experiments not reported here , we found that taking into account the brevity penalty at the sentence level can cause large fluctuations in lattice MBR performance on different test sets . we would have to set up too many of them depending on the various shapes and functions of bent trajectories']


Cluster  2027
['Child sexual abuse ( CSA ) is a preventable public health problem typically addressed with either after-the-fact interventions or prevention programs focused on teaching children to protect themselves and report abuse .', 'The experience of sexual abuse in childhood is a serious public health problem that is associated with suicidal behavior in numerous cases .', 'Sexual abuse can lead to long-lasting , even life-long , consequences and is a serious problem on an individual , familial and societal level .', 'Since child sexual abuse may endanger the life and well-being of the child , it is a serious problem that requires urgent action .', 'The under-reporting of child sexual abuse by victims is a serious problem that may prolong the suffering of victims and leave perpetrators free to continue offending .', 'Sexual assault poses a serious health problem to both the survivor and the health system .', 'Sexual abuse of deaf youth is a serious problem that needs to have attention given to it in a way that will lead to real changes in the lives of the boys and girls affected .', 'Child sexual abuse ( CSA ) is a serious public health problem that increases risk for physical and mental health problems across the life course .', 'Childhood sexual abuse is a severe problem worldwide .', 'Childhood sexual abuse is a serious problem .', 'Despite numerous studies and publications, there is still a common expectation that a medical assessment can confirm or rule out child sexual abuse (CSA)', 'Recent literature pertinent to adult survivors suggests that childhood sexual abuse is a serious problem , and that disclosure is on the rise .', 'Adolescents who have sexually abused may pose a serious problem for both the community and the treatment provider concerning the management of risk and the application of effective intervention strategies .', 'Child sexual abuse ( CSA ) is a serious problem not only in the community but also in institutional settings such as youth-serving organizations , churches , and schools .']


Cluster  1079
['Surgical site infections ( SSIs ) are a serious concern in health care , and wound contamination by endogenous skin flora is a major factor in the development of SSIs .', 'Infection is a serious problem for patients after implantation surgery , which is difficult to treat with antibiotic therapy .', 'Postoperative infections remain a serious concern after cesarean delivery , the most common major surgical procedure in the United States .', 'Postoperative infection is a serious problem in New Zealand and internationally with considerable human and financial costs .', 'Surgical site infections ( SSI ) represent a serious health problem that occur after invasive surgery , thus new antimicrobial biomaterials able to prevent SSI are needed .', 'Surgical site infection ( SSI ) following gynecologic oncology surgery is a severe problem for both patient and surgeon in terms of increasing morbidity , length of hospital stay , anxiety , and costs .', 'Microbial infections from post-surgery or other medical-related procedure is a serious health problem .', 'Surgical site infections ( ICHM ) remain a serious problem in the proximal GIT surgery , with incidence rates from 5 % to 26 % in planned procedures , and up to 40 % in urgent procedures .', 'Surgical site infection ( SSI ) remains so far a serious problem and major challenge , particularly in contaminated tissue-deficient repairing .', 'Infections caused by methicillin-resistant Staphylococcus aureus pose a serious problem postoperatively .']


Cluster  1314
['Chronic wounds are a significant cause of morbidity and mortality for many patients and therefore constitute a serious clinical concern .', 'Wound infection is a serious problem in the home care patient .', 'Chronic wounds are still regarded as a serious public health concern , which are on the increase mainly due to the changes in life styles and aging of the human population .', 'Chronic wounds seem to be a severe problem in terms of socioeconomical meanings due to the fact , that the average age of patients suffering from these wounds rises steadily .', 'Wound care is a serious healthcare concern , often complicated by prolonged inflammation and bacterial infection , which contributes significantly to mortality and morbidity .', 'Chronic infected non-healing wounds represent a serious concern for health care systems .', 'Wounds continue to be a serious medical concern due to their increasing incidence from injuries , surgery , burns and chronic diseases such as diabetes .', 'The biological process of wound healing is one of the most complex occurrences during our lives turning a serious public health problem .', 'Chronic wounds seem to be a severe problem in terms of its socioeconomical meaning due to the fact that the average age of patients suffering from these wounds is rising steadily .', 'Chronic wounds constitute a debilitating health care problem with significant clinical and social implications .', 'Chronic wounds represent a serious problem for patients in terms of quality of life , lost employment time , and loss of income .', 'Wound pain is a serious problem for people with chronic wounds .']


Cluster  101
['During followup, suture dehiscence was observed in 15/28 interrupted and 16/28 running sutures (p\u2009>\u20090.', 'Use of TCD-11091 was safe and associated with significantly lower incidence of adhesion and severity of adhesions compared with non-treatment procedure.', 'Cyanoacrylate tissue adhesives produce cosmetic outcomes that are not statistically significantly different than sutures; furthermore, they are associated with fast application, easy wound care, and patient satisfaction.', 'This prospective, observational study included 128 patients from Kumamoto, Japan (97 in the adhesive strapping group, and 31 in observation group), from 2012-2015.', 'Thirty patients with adhesive capsulitis of the shoulder were randomized to the hyaluronate group (n= 16) or the tramadol group (n= 14).', 'Adhesions frequently originate from the implant and protruding parts of fixation devices , presenting a serious clinical problem with potentially detrimental consequences .', 'In congenital heart operations through a median sternotomy, the Zip surgical skin closure device was an excellent choice for improving the cosmetic appearance and reducing the wound closure time.', 'No difference between the titanium coated sutures and non-coated sutures was seen in the POSAS assessment, neither for the patient scale at 14, 42, 72 and 180\xa0days, nor for the observer scale on the same dates.', 'The purpose of this study was to compare a unique zip-type adjustable coaptive tape-based skin closure device to traditional subcuticular sutures in three domains: time, cosmesis, and wound closure-related outcomes in cardiac implantable electronic device (CIED) procedures.', 'Compared to a bilayered closure, the pulley technique resulted in significantly reduced closure time (p < .', 'Postoperative pain at 8\u2009h, 24\u2009h, 7\u2009days and 30\u2009days was less when glue was used instead of sutures for all measures (P\u2009<\u20090·001).', 'Thirty patients with adhesive capsulitis were included in a prospective, double-blind, randomized controlled trial.', 'Patients were intraoperatively randomized to TachoSil or current practice immediately before primary dura closure by suturing ± duraplasty.', 'No difference between the titanium coated and non-titanium-coated suture material was seen in the POSAS assessment in regard to scar quality and wound healing.']


Cluster  766
['Pseudomonas aeruginosa is one of the most common causes of nosocomial infections , and its multi-drug resistance has been a serious problem worldwide .', 'As colonizers of medical-device surfaces , Pseudomonas aeruginosa strains present a serious source of infection and are of major concern .', 'A vexing problem in cystic fibrosis ( CF ) pathogenesis has been to explain the high prevalence of Pseudomonas aeruginosa biofilms in CF airways .', 'Infections with Pseudomonas aeruginosa are a severe problem for hospitalized patients and for patients suffering from cystic fibrosis .', 'Serious infection due to strains of Pseudomonas aeruginosa that exhibit resistance to all common antipseudomonal antimicrobials increasingly is a serious problem .', 'Pseudomonas aeruginosa biofilm-associated infections are a serious medical problem , and new compounds and therapies acting through novel mechanisms are much needed .', 'Pseudomonas aeruginosa is a Gram negative , opportunistic biofilm forming pathogenic bacterium which is developing as a serious problem worldwide .', 'Pseudomonas aeruginosa ( PA ) bloodstream infection ( BSI ) is a common complication in patients with acute leukemia ( AL ) , and the prevalence of antibiotic-resistant strains poses a serious problem .', 'Pseudomonas aeruginosa is an increasingly prevalent pathogen that has become a serious health concern due to an increasing incidence of multidrug-resistant ( MDR ) hospital-acquired infections .', 'The rapid emergence of drug resistance upon treatment of Pseudomonas aeruginosa infections with fluoroquinolones is a serious concern .', 'Chronic pulmonary infections with Pseudomonas aeruginosa remain a serious problem in patients with cystic fibrosis .', 'Antimicrobial resistance in Pseudomonas aeruginosa is a serious clinical problem .', 'The emergence of Pseudomonas aeruginosa strains resistant to carbapenems , fluoroquinolones and amikacin , which were defined as multidrug-resistant ( MDR ) strains , is a serious problem in Japan .']


Cluster  2125
['Obesity is a serious health problem , especially in patients with long-term mental disorders .', 'Less than 10 % of obese adults accept that they have a serious weight problem , survey finds .', 'Obese patients, mainly females, feel uncomfortable and unsatisfied with their physical appearance; they have a wrong perception of their image and consequently diminish their self-esteem, sometimes showing difficulties in functional areas such as work, relationship, social activity', 'One barrier to effectively treating weight issues among adolescents is that they tend to use social comparison instead of objective measures to evaluate their own health status', 'Despite educational campaigns , increased awareness , and improved treatment options , the high prevalence of mental illness and comorbid obesity remains a serious problem .', 'The aim of this study was to prospectively investigate whether visceral fat, as measured by hip-to-waist ratio and waist circumference, affects treatment outcome in patients with major depressive disorder in patients attending a hospital psychiatric care unit in Denmark.']


Cluster  906
['A total of 128 parturients having elective caesarean section under spinal anaesthesia were enrolled.', 'Previous caesarean section is considered the main risk factor for uterine rupture', 'After institutional ethics committee approval, 20 women with impalpable lumbar spinous processes presenting for elective caesarean delivery were recruited.', 'This study may help in determining the optimal way to induce labor after failure of a first Propess®, an unresolved problem to date.', 'Fifty women with singleton pregnancies undergoing cesarean delivery were randomly divided into intervention and control groups, each group containing 25 subjects.', 'In all, 152 Chinese parturients with singleton breech presentation were randomly divided into 2 groups, each with 76 patients.', 'For this study, 213 nulliparous women who planned vaginal delivery were enrolled and assessed daily until they completed three outcomes: (1) pain resolution; (2) opioid cessation; and (3) self-assessed functional recovery to predelivery level.', 'In this randomized controlled parallel single-center trial, 58 nulliparous in second-stage arrest of labor with fetus in cephalic presentation and OPP diagnosed by US were randomly assigned to group A where the fetal spine position was not known by the operator or to group B where the operator knew it.', "CSP is a serious maternal complication that risks the mother 's life , and this problem is growing because of the increased cesarean rates .", 'For these women prediction of cesarean section scar performance is still a serious clinical problem .', 'To evaluate the value of the NP score for the prediction of a successful ECV in a Portuguese obstetrical population, and to evaluate maternal and fetal safety.', 'Excessive use of cesarean sections ( CSs ) is a serious problem worldwide .', 'A total of 144 nulliparous women with singleton breech presentation were randomly divided into the intervention group and the placebo group, with 72 subjects in each group.', 'The increasing rate of caesarean deliveries ( CD ) has become a serious concern for public health experts globally .']


Cluster  1077
['DESIGN: Pilot randomized study.', 'This study used a randomized clinical trial design.', 'The current study used a prospective controlled design.', 'A randomised controlled trial design was used.', 'This study was a randomized controlled quasi-experimental study.', 'Before-after randomized uncontrolled trial.', 'The study was designed as randomised control trial coupled with before-after measurement of outcome variables.', 'A pre-posttest experimental pilot study was conducted.', 'The study design was a pretest-posttest control group.', 'A stratified randomized control trial with process evaluation is proposed.', 'We conducted a quasi-controlled trial with stratified randomisation, using a pre-test/ post-test design.', 'Randomised feasibility trial.', 'Quasi-experimental before -after study.', 'This study is a randomized controlled study employing a pre-/post-test design with a control group.', 'The statistical analysis plan was designed by the trial executive committee and reviewed and approved by the trial steering committee.', 'A randomized controlled trial design was used.']


Cluster  853
['The results show that EEA provides a direct surgical corridor to the CCJ, allowing an adequate decompression as with the more invasive transoral route.', 'Irrespective of the varying morphological presentation of the LAA, the procedural success rates, interventional characteristics, and safety events did not significantly differ among patients receiving an interventional LAA closure.', 'Patients operated with the transosseous technique had significantly less pain, especially from the 15th postoperative day: In the third week, the mean NRS value for the anchor group was 3.', 'The setup time, surgical time, and fluoroscopic exposure time were lower and the differences were statistically significant in the lateral decubitus group compared with the traction table group.', 'Despite obtaining satisfactory results in most patients, this technique has several downsides: it is time consuming, there is the risk of iatrogenic deformities unless it is carried out precisely, the postoperative recovery is often very long, and there is a significant failure to maintain long-term correction.', 'No significant differences were found between the 2 arthroscopic repair techniques in terms of functional and radiological results.', 'There were no statistically significant differences in the clinical outcomes between two procedures based on FAOS, FAAM, recurrence rate of instability, and stress radiographs.', 'Onychoscopy, being handy, inexpensive, and noninvasive, has the potential to reduce the invasive procedures.', 'Although the RP procedure has a lower morbidity rate compared to the TP procedure , more skill is required to overcome the drawback of the narrow working space and fewer anatomical landmarks .', 'We found a decrease in surgical time of 76.', 'The introduction of minimally invasive procedures has increased acceptance due to their efficacy, safety, and relatively long-lasting and natural results.', 'MIS methods minimized soft tissue complications and achieved comparable radiological reductions but clinical outcomes were poorer, with percutaneous methods having the worst outcomes.', 'This increasing risk of infection over a \xa0 long follow-up period , represents the biggest drawback of this method and , therefore , needs to be discussed extensively with the patients and parents when considering this procedure as an alternative to ablative surgery .', 'Significant contracture appears to be a drawback of this technique , and we feel that the method should be improved before its clinical application on patients .', 'In addition to the early benefits regarding hospital stay and complications, we have found that at a mean of six years there was no increase in malalignment, pain or function with MIS techniques.']


Cluster  297
['Overweight and obesity in many countries have developed into a serious health problem by themselves and by their impact on other pathologies such as insulin resistance , type 2 diabetes , hypertension , heart disease and cancer .', 'Obesity is proving to be a serious health concern in the developed world as well as an unwanted component of growth in livestock production .', 'There is a need to increase the awareness of companion animal obesity as a serious medical concern within the veterinary profession .', 'The results show that overweight and obesity are a serious public health problem and confirm the importance of breakfast to prevent overweight .', 'Obesity among Pasifika people living in New Zealand is a serious health problem with prevalence rates more than twice those of the general population ( 67 % vs 33 % , respectively ) .', 'Obesity , a serious public health problem , occurs mainly when food consumption exceeds energy expenditure .', 'The current study indicates that obesity and underweight in combination with smoking may emerge as a serious public health problem .', 'Obesity is a serious concern worldwide , for which the restaurant industry holds partial responsibility .', 'Obesity is a severe problem in Blacks , particularly in women .', 'Overweight and obesity is a serious problem worldwide related to cardiovascular and other diseases .', 'This high prevalence of overweight is a serious concern for public health in Jordan .', 'Obesity T2DM has become a serious problem in Japan as in Western countries , with over-eating and physical inactivity .', 'The results are consistent with recent findings on the Navajo Health and Nutrition Survey that overweight is a serious public health concern across the lifespan in the Navajo , and that the problem begins in childhood .', 'With 80 % of its population overweight , 47.5 % obese , and having the eighth fattest population worldwide , Kuwait has a serious obesity problem .', 'Excess of weight is a serious public health concern in almost all countries , afflicting people of different ages and socioeconomic backgrounds .', 'Thus , the understanding of excessive body weight as a serious health and social problem sets one of the priorities in the area of public health .', 'Overweight and obesity are now considered as a serious health problem , and a very important risk factor for many diseases .', 'Overweight and obesity seems to be a serious health problem , affecting more prominently people in the lower SES .', 'Obesity has become a serious public health problem all over the world , and prevalence of obesity has increased in cats .', 'Overweight and obesity are considered a serious health problem in Thailand .', 'Rising prevalence of excess weight in children and adolescents is a serious public health problem in both developed and developing countries , associated with a growing burden of chronic non-communicable diseases in youth and adults .', 'Elevated means for BMI and WHR indicated that obesity ( BMI ≥30.0 ) was a serious public health problem in these three kampungs , affecting about 5 % of males and 14 % of females .', 'Childhood obesity is a serious public health problem resulting from energy imbalance ( when the intake of energy is greater than the amount of energy expended through physical activity ) .', 'Excessive body fat accumulation can result in obesity , which is a serious health concern .', 'Overweight and obesity are considered a serious health problem .', 'Obesity in human populations , currently a serious health concern , is considered to be the consequence of an energy imbalance in which more energy in calories is consumed than is expended .']


Cluster  203
['Sixty-eight consecutive patients that were referred for CE were included.', 'Data from 712 admissions from 594 patients across the four inpatient units were used for this study.', 'We performed a retrospective analysis of patients admitted to the intensive care unit over a 4\xa0year period.', 'This study enrolled 110 consecutive patients between September 2008 and February 2012.', 'This study enrolled 123 patients into the acute phase, of whom 107 entered the maintenance phase (Group A: 54; Group B; 53).', 'Data were collected from 15 maintenance, 20 acute exacerbation, and 50 hospitalization events.', 'A total of 5157 unique patient-admissions were stratified into the two study groups.', 'A total of 137 consecutive patients were reviewed at our multidisciplinary conference during the 10-month period.', 'Retrospective analysis of medical records of 200 patients assessed and followed by the authors at a private outpatient clinic.', 'Patients treated at single center between 2012 and 2015 were observed prospectively.', 'A total of 248 outpatients were analyzed.', 'At four Japanese hospitals, 319 examinees undergoing CCE were enrolled retrospectively.', 'This observational, retrospective study evaluated the appropriateness of startup of long-term AST in medical records using a broad variety of international criteria and guidelines and using a validated screening instrument.', 'This is a retrospective observational study on 357 patients consecutively visited from September 2013 to December 2017.', 'The aim of this study was to determine if there were trends in survival over the last decade and to compare patient populations, treatment options, and survival rates between 4 high-volume centres, and hence determine which factors were associated with survival.', 'Retrospective medical record review.', 'We studied 11,266 patients during 25,978 admissions; the use of CROS lowered NEWS total scores in 40% of included patients.', 'CCHF patients (n = 100) who were hospitalized between 2007 and 2010 were included.', 'We reviewed all patients admitted to our Department of Intensive Care with SAH over a 3-year period.']


Cluster  683
['Two patients with left unilateral congenital anophthalmia were prospectively followed.', 'Retinopathy of prematurity ( ROP ) is a serious problem of preterm infants which may lead to impairment of vision and even to blindness if untreated .', 'Instrument-based vision screening for preschool-aged children can be effectively implemented into primary care practice, results in substantially improved rates of completed vision screening at well-child visits, and may result in a reduction in unnecessary referrals to eye care specialists.', "The physician should never fail to examine the infant 's eyes lest he overlook a serious problem .", 'According to the general principles of screening , detection of visual impairment in children is worthwhile , since the condition is a serious health problem , reliable diagnostic tests are available and effective treatment is possible in most instances of ocular and visual dysfunction .', 'Retinopathy of prematurity ( ROP ) is a serious problem which potentially can lead to blindness .', 'Through a literature review of new and emerging technologies , screening criteria , and analysis of a national survey of pediatric ophthalmologists and retinal specialists , the authors found the shortage of ophthalmology workforce for ROP a serious and growing concern .', 'Instrument-based vision screening increased completed screening among 3- to 5-year-old children from 54% to 89% in the phase 1 group and from 65% to 92% in the phase 2 group.', 'Pediatric uveitis may be a serious health problem because of the lifetime burden of vision loss due to severe complications if the problem is not adequately treated .']


Cluster  1631
['This was a prospective, single-center, open-label, noncomparative clinical trial conducted in female subjects aged 18-60 years with Fitzpatrick skin phototype I-IV and confirmed sensitive skin.', 'Skin phototype questionnaires usually ask similar questions, but they differ in how the answers can be given.', 'The detailed questionnaire with separate answers to 2 detailed questions about\xa0tendency to burn and ability to tan has good reproducibility, correlates best with objective skin measurements and is therefore the recommended method for determining skin phototype.', 'This multicenter, double-blind, placebo-controlled trial randomized healthy 35- to 65-year-old women with Fitzpatrick skin types I-IV and Glogau classification types II-III to a multicomponent nutritional supplement or placebo for 24 weeks.', 'A total of 149 participants completed 3 skin phototype questionnaires distributed twice with median 3\xa0months interval: (i) a Fitzpatrick questionnaire (FST-q) with combined answers about tendency to burn and ability to tan, (ii) a detailed questionnaire (Detail-q) with separate answers to 2 detailed questions about burn and tan and (iii) a short questionnaire (Short-q) with separate answers to 2 simplified questions about burn and tan.']


Cluster  247
['Non-metastatic RPS cases from 2004 to 2014 in the National Cancer Database were analyzed.', 'Of 3141 RPS cases identified, 70.', 'Fibroplastic endomyocarditis with eosinophilia : presentation of a fatal case and diagnostic considerations on eosinophilic leukemia .', 'E. coli pyomyositis has emerged as a serious problem among our patients with hematologic malignancy .', 'There were 30 cases of parapneumonic empyema.']


Cluster  490
['Dental caries remains a serious problem due to its detrimental effects on individual health and quality of life .', 'Dental caries and periodontal disease are the most common oral diseases', 'Though both the agents showed the minimal smear layer with the patent dentinal tubules, Carie care showed patent dentinal tubules with a clearly exposed peritubular and intertubular collagen network.', 'Caries is a serious health problem affecting the Polish population , mostly due to a low level of health awareness , which is reflected in irregular check-ups and a tendency for patients to visit the dentist only when they are already experiencing pain .', 'The chronic cumulative nature of caries makes treatment needs a severe problem in adults .', 'While the prevalence of dental caries and periodontal conditions was low , oral cancer and OPMDs is a serious concern .', 'Previous studies have shown during the orthodontic treatment, the prevalence of active caries lesions (ACL) in 30 to 70% of patients.', 'Dental caries is a diet-associated disease which continues to be a serious health problem in most industrialized and developing countries .', 'Carie Care treated surface exhibited better surface morphology of residual dentin.', 'Although the prevalence of dental caries is continuing to decline , it still affects a majority of the US population and can be a serious problem for those afflicted .', 'While the prevalence of dental caries and periodontal conditions was low , oral cancer and OPMDs is a serious concern .', 'At the end of the 19th century dental caries had become a serious health problem in many countries , especially among children and young people .', 'The occurrence of caries lesions adjacent to restorations is a serious problem in Dentistry .', 'Dental caries or tooth decay is a preventable and multifactorial disease that affects billions of people globally and is a particular concern in younger populations .', 'Secondary caries continuous to be a serious problem although amalgam has been improved to a large extent .']


Cluster  14
['Inferring the answer of a yes/no query is simply a matter of parsing a query , adding its semantic parse to the KB , and recomputing the partition function -LRB- which is tractable in TML -RRB- . the fact that the configurability of PRESENTOR at the micro-planning level is restricted to the lexicalization and the linguistic realization of rhetorical relations', 'Inferring the answer of a yes/no query is simply a matter of parsing a query , adding its semantic parse to the KB , and recomputing the partition function -LRB- which is tractable in TML -RRB- . the fact that the configurability of PRESENTOR at the micro-planning level is restricted to the lexicalization and the linguistic realization of rhetorical relations', 'allows for either kind of response . the logical nature of automated planning systems , which do not handle probabilistic grammars , or force ad-hoc approaches for doing so ( Bauer and Koller , 2010 )', 'A key limitation is the logical nature of automated planning systems , which do not handle probabilistic grammars , or force ad-hoc approaches for doing so ( Bauer and Koller , 2010 )', 'A serious limitation of the current implementation is the fact that the configurability of PRESENTOR at the micro-planning level is restricted to the lexicalization and the linguistic realization of rhetorical relations', 'allows for either kind of response . the logical nature of automated planning systems , which do not handle probabilistic grammars , or force ad-hoc approaches for doing so ( Bauer and Koller , 2010 )']


Cluster  1055
['Both GBR approaches for the restoration of atrophic posterior mandible achieved similar results regarding complications, vertical bone gain and implant stability.', 'Thirty-four children who required cranioplasty with fronto-orbital advancement were recruited consecutively.', 'There is a low incidence of serious complications with the Le Fort I maxillary osteotomy , but avascular necrosis is a serious problem that occurs at a higher frequency in the cleft population compared to non-cleft patients .', 'Twenty-four patients with a extraction socket of maxillary incisor were treated with spontaneous healing (control group) or by applying a micro-titanium stent as a facial pressure bearing device over the facial bone wall (test group).', 'For some anophthalmic patients , the contracted socket is a severe problem that precludes the wearing of a prosthesis .', 'En masse retraction of the six anterior teeth by using zygomatic bone anchorage proved to be an efficient method for the correction of a severe overjet problem .', 'Bone defects represent a serious problem in cranio-maxillofacial surgery .', 'To assess the efficacy of autologous dental pulp mesenchymal stem cells delivered in a collagen matrix for post-extraction socket healing, a single-centre, double-blind, randomised, split-mouth, controlled clinical trial was performed.', 'To evaluate the efficacy of applying a micro-titanium stent as a pressure bearing device on extraction socket remodeling of maxillary anterior tooth.', 'The study population comprised 20 completely edentulous patients (11 males) aged 60 years and older with severe mandible resorption.', "With the limits of this study it was concluded that granulomatous tissue left in infected fresh sockets doesn't injury dental implant outcome.", 'The treatment of an infected socket with a severe facial dehiscence/ fenestration defect presents a therapeutic dilemma to the dental team .', 'This clinical report presents a successful reconstruction of a severe anterior mandibular alveolar bony defect as a result of impacted teeth extraction and periodontal problem in a 50-year-old healthy female patient .']


Cluster  8
['Methicillin-resistant Staphylococcus aureus ( MRSA ) isolates is a serious public health problem whose ever-increasing rate is commensurate with the pressure it is exerting on the healthcare system .', 'Methicillin-Resistant Staphylococcus aureus ( MRSA ) , which is resistant to many antibiotics , creates a serious problem for human health if present in food .', 'The high resistance acquired by MRSA needs a serious concern and efforts should be carried out for the discovery of better therapeutics .', 'The increasing prevalence of community-acquired MRSA and its emerging antibiotic resistance in foods is a serious problem for public health .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) infections are a serious global problem , with considerable impact on patients and substantial health care costs .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) poses a serious problem in some geographic areas .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) poses a serious problem in dairy animals suffering from mastitis .', 'Community-associated methicillin resistant Staphylococcus aureus ( CA-MRSA ) has become a severe health concern because of its treatment difficulties .', 'Due mainly to indiscriminate abuse of antibiotics , the methicillin-resistant strain known by its initials as MRSA is the most extended nosocomial infection globally and is a severe community and hospital healthcare problem .', 'Today , significant increase in the prevalence and emergence of methicillin-resistant Staphylococcus aureus ( MRSA ) is a serious public health concern and is likely to have a dramatic negative impact on many current medical practices .', 'Infections with MRSA strains that are resistant to beta-lactams and other types of antibiotics are a serious therapeutic problem - first , because in such cases only a limited spectrum of antibiotics can be used ; and second , because such infections require prolonged hospitalization and result in economic losses .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) is spreading worldwide and poses a serious public health problem , being present in hospital settings and communities .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) is a life-threatening pathogen in humans and its presence in animals is a public health concern .', 'The growing emergency of infections with community-acquired methicillin-resistant Staphylococcus aureus ( CA-MRSA ) secreting the Panton-Valentine toxin ( PVL ) has become a serious health problem with epidemic proportions .', 'MRSA bacteraemia is now a serious problem in children in England and Wales .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) isolates are a serious public health problem whose ever-increasing rate is commensurate with the pressure it is exerting on the healthcare system .', 'Antibiotic resistance has been regarded as a serious problem during Staphylococcus aureus treatment , especially methicillin-resistant S. aureus ( MRSA ) .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) strains are a major cause of hospital-acquired infections and are considered a serious public health concern .', 'Bacterial contamination of surfaces with methicillin-resistant Staphylococcus aureus ( MRSA ) is a serious problem in the hospital environment and is responsible for significant nosocomial infections .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) continues to be a serious human pathogen , and particularly the spread of community associated (CA)-MRSA strains such as USA300 is a concern , as these strains can cause severe infections in otherwise healthy adults .', 'Therefore , MRSA strains have become a serious problem in the clinical setting .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) poses a serious therapeutic problem worldwide , and its frequency in most African countries has not been reported .', 'Infections caused by hard-to-treat methicillin-resistant Staphylococcus aureus ( MRSA ) are a serious global public-health concern , as MRSA has become broadly resistant to many classes of antibiotics .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) has emerged as a serious problem in the community .', 'Methicillin-resistant staphylococcus aureus ( MRSA ) bacteremia is a life-threatening illness and a major global health care problem .', 'Infections caused by clinical methicillin-resistant Staphylococcus aureus ( MRSA ) are a serious public problem .', 'The presence of enterotoxigenic S. aureus strains , including MRSA , in raw milk and dairy products , raises a serious public health concern , because these strains may cause food poisoning outbreaks , be disseminated to the population , or both .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) has become a serious problem in intensive care units , because of development of multiresistance , and also intrinsic resistance to beta-lactam antibiotics .', 'Nosocomial infections involving epidemic methicillin-resistant Staphylococcus aureus ( MRSA ) strains are a serious problem in many countries .', 'PRACTICAL APPLICATIONS : Methicillin-resistant Staphylococcus aureus ( MRSA ) is a serious concern in hospitals because of its known antibiotic resistance .', 'Nosocomial infections caused by methicillin-resistant staphylococci ( MRSA ) pose a serious problem in many countries .', 'Infection by methicillin-resistant Staphylococcus aureus ( MRSA ) presents a serious problem , as these organisms are resistant to a wide range of antibiotics .', 'The prevalence of community-acquired meticillin-resistant Staphylococcus aureus ( CA-MRSA ) strains has become a serious problem worldwide .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) is a serious nosocomial problem , globally distributed .', 'MRSA infection poses a serious problem for physicians and their patients .', 'Emergence of drug resistant strains especially methicillin resistant Staphylococcus aureus is a serious problem in hospital environments .', 'MRSA remains a serious problem because of the high incidence and multidrug resistance of the strains , even for strains isolated from foods , food environments and food handlers .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) infection is a serious clinical problem worldwide .', 'MRSA is a serious clinical and epidemiologic problem .', 'Appearance of MRSA strains in the community is becoming a serious public health problem .', 'The results indicate that MRSHo with high antibiotic resistance and unknown SCCmec might become a serious problem in the future for the treatment of patients such as children .', 'The global spread of methicillin-resistant Staphylococcus aureus ( MRSA ) is a serious problem , particularly in mainland China .', 'Methicillin-resistant Staphylococcus aureus ( MRSA ) , that have acquired multiresistance to all classes of antibiotics , have become a serious nosocomial problem .', 'In Japan , most strains of MRSA now represent high level resistance to all antibiotics , except for a few antibiotics , such as vancomycin and arbekacin , and therefore , they posed a serious problem clinically and epidemiologically , via immuno-suppressed inpatients , in particular , as the causative pathogen of nosocomial infection .', 'Staphylococcus aureus , particularly methicillin-resistant S.aureus ( MRSA ) , is a life-threatening pathogen in humans , and its presence in food is a public health concern .', "Infections with methicillin-resistant Staphylococcus aureus ( MRSA ) and methicillin-resistant coagulase-negative Staphylococcus ( MR-CNS ) are a serious problem in hospitals because these bacteria produce penicillin-binding protein 2 ' ( PBP2 ' or PBP2a ) , which shows low affinity to β-lactam antibiotics ."]


Cluster  1696
['Application of adhesive after acid etching may increase the retention of pit-and-fissure sealants and improve clinical effectiveness.', 'Use of adhesives during pit-and-fissure sealant application does not significantly enhance sealant retention nor decrease marginal discoloration.', 'To clinically evaluate the retention, marginal discoloration and caries incidence of pit-and-fissure sealants applied using four bonding protocols: conventional acid etching, etch-and-rinse adhesive, multimode universal adhesive and self-etch adhesive used after acid etching.']


Cluster  2140
['Treatment with the desensitizing or placebo control gels was randomly assigned to one-half of the maxillary teeth of 42 patients in a split-mouth design.', 'In this multicenter, double-blind, parallel-group controlled study, the authors randomly assigned 375 participants with dentinal hypersensitivity to 1 of 2 mouthrinse groups: KO (189 participants) and placebo (186 participants).', 'Application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde before HP whitening reduced the risk and severity of dental sensitivity, without altering the effectiveness of whitening.', 'The difference in risk of developing tooth sensitivity between the desensitizing gel group (31.', 'For well over a century , there has been cognizance that sensitivity is a serious problem , that it arises when the dentin and cementum are exposed , that fluid movement within the dentinal tubules acts as a provocative stimulus , that tubules can be sealed off ( apparently in most instances ) without damage to the tooth or the dental pulp , and that the problem can also be at least partially resolved by suppressing nerve firing within the pulp .', 'Clinical relevance : Dentine hypersensitivity is a persistent and a troublesome clinical condition which at times is under diagnosed by dental professionals who may struggle to resolve the problem to their patients ’ satisfaction successfully .', 'The treatment of dentinal hypersensitivity can be a serious problem in professional dental practice .']


Cluster  1701
['A dermocosmetic cream containing 0.', 'In this prospective, open-label trial, 10 infants, with mild/moderate cradle cap enrolled at the Dermatology University Clinic of Catania (Italy) used the tested gel cream twice daily for 30\xa0days.', 'To compare the efficacy and safety of an antiaging cream containing 0.', 'To assess by clinical/laboratory/instrumental evaluation the efficacy/tolerability of a gel cream containing piroctone olamine (antifungal), biosaccharide gum-2 (antifungal), stearyl glycyrrhetinate (anti-inflammatory), and zinc l-pyrrolidone carboxylate (zinc-PCA) (antiseborrheic) in the treatment of mild/ moderate cradle cap.', 'To compare the efficacy and safety of topical solution of 0.', 'To evaluate the effects of permethrin 5% topical gel vs.', 'Our results indicate that the tested gel cream may represent a valid option to treat mild-to-moderate forms of cradle cap and support its antifungal and antibacterial properties.']


Cluster  2276
['This is a randomized controlled trial comparing CAC with standard colonoscopy (SC) in patients undergoing screening or surveillance colonoscopy.', 'Colonoscopy can be painful and uncomfortable.', "Technically 'difficult' (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures.", 'The aims of this study were to determine patient tolerance and acceptability of OC, computed tomography colonography (CTC) and colon capsule endoscopy (CCE) and also to determine the choice of investigation made by fully informed members of the lay public.', 'This was a prospective study of 451 consecutive outpatient colonoscopies performed by a single experienced endoscopist.', 'All colonoscopies performed by 3 gastroenterology fellows without prior experience were eligible for the study.', 'A total of 203 colonoscopies were analyzed, 101 in CAC and 102 in SC.', 'We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy.', 'This was a prospective single-blinded study of patients undergoing outpatient colonoscopy.', 'Fifty patients undergoing colonoscopy with ACD assistance were compared to 100 matched controls.']


Cluster  1003
['In experience hand, PLMA offers advantages over the ETT in airway management in the patients undergoing beating-heart CABG.', 'Patients with AECOPD-induced respiratory failure received orotracheal intubation mechanical ventilation and were randomly divided into bronchoscopic sputum suction group or general sputum suction group, and who were then treated with sequential invasive-noninvasive mechanical ventilation at PIC window (both groups).', 'Percutaneous dilatational tracheostomy (PDT) in critically ill patients is often led by optical guidance with a bronchoscope.', "Visualization of the tracheal landmarks was rated as 'very good' or 'good' in all but one case.", 'Between September 2013 and July 2015, 66 patients with inoperable malignant airway obstruction received stent placement fluoroscopically (33 in either group).', 'The placement of RBMS in patients with inoperable malignant airway obstruction is feasible and safe, and it significantly reduces restenosis and improves overall survival compared with the placement of CBMS.', 'With the help of IMR and ECG-synchronized prospective-triggered technology, the bronchial artery anatomy can be accurately depicted in patients with massive hemoptysis.', 'One major problem with this technique is that it may not possible to pass a new tube over the bougie into the trachea , because the tip of the tube can collide with tissues around the glottis .', 'The shape of the P-P curve could be used to detect the site of maximal obstruction for the optimal positioning of the stent and assess the need for additional procedures in real time in patients with bronchial obstruction.', 'The success rate of the tracheal tube passing through the lower pathway was significantly higher in the intervention group than the conventional group (79.', 'Intraoperative bronchospasm can be a life-threatening problem .']


Cluster  2218
['The results showed that palliative care health professionals with a higher level of burnout have an alteration of inhibition, working memory and decision-making.', 'The non-burnout professionals were significantly older and slept more than the professionals with more than one altered dimension; in addition, they had greater job seniority in the unit than those with a single altered dimension and did physical exercise more frequently than either of the burnout groups.', 'To analyse the association between psychological, labour and demographic factors and burnout in palliative care nursing.', 'Our multivariate models were very accurate in explaining burnout in palliative care nurses.', 'The younger professionals, with more job seniority in the units of palliative care, and less hours of sleep and physical activity showed higher levels of burnout.', 'Palliative care health professionals have reported high levels of burnout.']


Cluster  295
['Spinal hydatid disease is rare and remains a serious health problem associated with high rates of recurrence .', 'Hepatic hydatidosis still remains as a serious problem in general surgery .', 'Hydatid disease in tropical areas poses a serious diagnostic problem due to the high frequence of cross-reactivity with other endemic helminthic infections .', 'Hydatid disease in childhood is a serious health problem in Turkey and other places where the parasite is endemic .', 'Hydatid cyst ( HC ) disease is a serious health problem in endemic areas .', 'Hydatidosis , or echincoccosis , is a serious medical and veterinary problem in many countries , particularly those with rural communities where there is a greater contact between dogs and domestic animals .', 'Hydatidosis is a serious Public Health problem in the Province of Río Negro , Argentina .', 'Hydatid cyst of the liver remains a serious public health problem in Tunisia .', 'Hydatid cyst ( HC ) disease is a serious health problem in endemic areas , solitary primary subcutaneous hydatid cyst is not frequent and the only symptom is generally a silent growing mass .', 'Hydatid cyst ( HC ) is a serious health problem in developing countries .', 'Hydatid disease of the liver still remains a serious medical problem .', 'Hydatid disease is a serious public health problem in endemic areas , and the management is controversial .', 'Liver hydatid disease remains a serious public health problem .', 'Hydatidosis is a serious problem in non-endemic countries due to the influx of immigrants from nations where preventive measures are inadequate .', 'Liver hydatid cyst with cystobiliary communication and superadded acute cholangitis is a serious clinical problem requiring the early diagnosis and surgery in the absence of endoscopic therapy .', 'Hydatid cyst disease is a parasitic infection caused by Echinococcus granulosus and poses a serious health problem in endemic areas , including our country .', 'Hydatid disease remains a serious health problem in Mediterranean countries .', 'A hydatid disease is a serious public health problem in Kazakhstan .', 'Nevertheless , hydatic disease is a serious public health problem in endemic areas .', 'Hydatidosis ( cystic echinococcosis , CE ) constitutes a serious public health problem worldwide .']


Cluster  453
['Middle dose (2.', 'Lokivetmab at a minimum monthly dose of 1 mg/kg provided quick onset (within one day) of a lasting effect in reducing pruritus and skin lesions with a good safety profile.', '3+3 rule-based, dose-finding study.', 'SAMURAI and SPARTAN were Phase 3 double-blind studies of patients with migraine, randomized to oral lasmiditan 50\u2009mg (SPARTAN only), 100\u2009mg, 200\u2009mg, or placebo to be taken within 4 hours of onset of migraine pain.', 'Pazopanib (400 mg twice daily) was administered orally from days 1 to 10 and from days 14 to 70.', 'The study population included 658 patients (30 mg n = 581; 10 mg n = 77).', 'In this open-label trial, LCM was initiated at 100\xa0mg/day and up-titrated to 200-600\xa0mg/day over 9\xa0weeks; SCB down-titration started when LCM dose reached 200\xa0mg/day.', 'Single oral doses of up to 600\xa0mg of LCZ696 were safe and generally well tolerated in healthy Japanese male subjects.', 'Using ES-IMRT, the median esophageal and lung mean doses reduced from 16 and 8Gy to 7 and 7Gy, respectively.', 'Twenty patients received 61 DEBDOX treatments.', 'The safety population comprised 1262 patients assigned placebo, and 654, 1265, and 1258 assigned lasmiditan 50\u2009mg, 100\u2009mg, and 200\u2009mg, respectively.', 'Overall, 738 administrations were observed from 166 patients of which 38 patients (22.', 'This study had two parts: single ascending doses of 5-450\xa0mg subcutaneous (s.c.) CJM112 (SAD) and multi-dose parallel groups of CJM112 15\xa0mg, 50\xa0mg and 150\xa0mg\xa0s.c. low frequency or high frequency (MD).', 'The median AVG dose (range 30-35min/day) remained relatively stable across the intervention and met the prescribed dose.', 'Eighty-one patients of the standard dose group and 81 of the double-dose group were analyzed.', 'The dose of 0.', 'Part 1 was a phase I, open-label, dose-escalation trial investigating up to six doses of ingenol disoxate to determine the maximum tolerated dose (MTD).']


Cluster  636
['Metastatic bone disease is found in 80 - 90 % of patients examined after death and is a serious problem in everyday practice .', 'Therefore , IL-18 may be useful for suppression of osteolytic bone metastasis which is a serious problem in patients of advanced breast cancers .', 'Ensuring the diagnosis , prevention , and treatment of long-term toxicities and comorbid conditions like osteoporosis in breast carcinoma survivors is a serious concern and is of increasing importance .', 'Bone metastases represent a devastating clinical problem in the most frequent neoplasies , especially in multiple myeloma , tumours breast , prostate and lung .', 'Chemotherapy associated osteoporosis is a severe problem in patients with malignant diseases as it increases the risk for fractures and deteriorates quality of life .', 'Osteonecroses ( ON ) are a serious problem after anti-leukaemic treatment in childhood and critically depend on treatment intensity .', 'Metastatic calcification progressed but was never a severe clinical problem .', 'Breast cancer is a serious health problem that preferentially metastasizes to bone .', 'This is a secondary analysis of patient-level data of advanced cancer patients with bone metastases who were treated with monthly zoledronic acid in the NCT00330759 clinical trial.', 'Metastatic bone disease is a serious clinical problem in patients with advanced cancer .', 'The skeleton is one of the frequent site of metastases in advanced cancer', 'Bone metastasis ( BM ) in patients with primary lung cancer poses a serious health problem .', 'The metastasis of breast cancer to the skeleton is a serious clinical problem resulting in hypercalcemia , bone fragility and insurmountable pain .', 'A potential drawback of gamma-secretase inhibitors was their ability to enhance osteoclastic maturation of normal circulating preosteoclasts induced by RANKL + M-CSF .']


Cluster  1205
['The return rate was 46.', 'Preliminary reliable change outcomes for the pilot cohorts showed a recovery rate of 47.', 'Indices of feasibility showed a recruitment and adherence rate of 53.', 'The successful repositioning rates were 53.', 'The total success rate of second-line therapy was 49.']


Cluster  813
['PONV is relatively infrequent , but remains a distressing problem resulting in negative surgical experiences and increased cost .', 'This observational clinical study evaluated a cohort of 100 consecutive patients (58 women and 42 men) with PVCs.', 'Seventeen patients underwent TPVI with Melody TPV at The Prince Charles Hospital between January 2009 and February 2016 with a median (range) age of 34 (R: 15-60).', 'The 5-year data from PREVAIL JAPAN show the clinical benefit of TAVR and suggest that balloon-expandable TAVR is an effective treatment option for Japanese patients with severe AS who are not suitable for surgery.', 'The OTRLASV-study is a cross-sectional, 5-centre study including patients who underwent ASV-treatment for at least 1 year.', 'Data from 37 patients were collected during a one-year period (twenty in the NIPARA device group and 17 in the control group).', 'We prospectively studied 209 patients undergoing PV isolation at a single institution over a 25-month period.', 'We conducted a repeated measures randomised trial of four VMs (two supine VM and two modified VMs), in healthy adult volunteers, with strains delivered using an adapted sphygmomanometer (manometer) or a VAD.', 'FDV is a serious and ongoing problem and front-line clinicians are in need of evidence-based guidelines to recognise and assist victims of FDV .', 'Based on medical records, we retrospectively evaluated patients aged ≤20\u202fyears who were initiated long-term NPPV at our hospital from January 2001 to December 2015.', 'Device evaluation demonstrated at least one episode of monitored NSVT in 50 out of 104 patients.']


Cluster  1276
['Forty patients, affected with different diagnosed types of onychomycosis in nails of the first toe, were randomly divided into two groups of 20 patients to be treated by PDT or IPL.', 'Thirty patients with mycologically confirmed onychomycosis received long-pulsed 1064-nm Nd:YAG laser therapy, moving the beam in a spiral pattern over the whole nail plate two times, with a 1-minute pause between passes.', 'Fractional CO<sub>2</sub> laser-assisted drug delivery is an effective and safe treatment option for onychomycosis.', 'To evaluate the onychoscopic patterns in confirmed cases of onychomycosis.', 'The study included 234 confirmed cases of onychomycosis.', 'Topical onychomycosis therapies are usually inadequate, and patient compliance to systemic therapies is poor.', 'Photodynamic therapy and IPL were effective for onychomycosis cure of any etiology.']


Cluster  480
['Plain chloroprocaine 10 mg/ml can successfully be used for low-dose spinal anaesthesia in perianal outpatient surgery.', 'Result of permeation test demonstrated that the cumulative amount of lidocaine released from HAMIN® cream was increased with time and slightly higher than EMLA cream.', 'To study the benefit of applying topical anesthetics or a 1:1 mixture of 1% lidocaine and TA at the TA injection site to alleviate pain during keloid treatment.', 'Hundred and twenty patients undergoing perianal surgery were enrolled and randomly allocated to receive 10, 20 or 30 mg of chloroprocaine 10 mg/ml intrathecally.', 'The aim of this study was to evaluate the effectiveness of new formulation of lidocaine topical anaesthetic using palm oil base, HAMIN® and to determine how fast this new formulation produces adequate numbness compared to the currently used EMLA cream, in the University of Malaya Medical Centre (UMMC) set-up.', 'In both studies, VAS scores were lower for lidocaine/prilocaine cream, with a mean VAS difference in study A of 1·9 [95% confidence interval (CI) 1·0-2·8] and in study B of 0·6 (95% CI -0·7 to 1·9).', 'We found that application of a eutectic mixture reduced the number of painful arterial punctures by 50% compared with placebo.', 'Application of topical anesthetics significantly relieved needle-stick pain, especially at sternum and auricular keloids; administration of a lidocaine mixture did not alleviate pain during injection.', 'Topical local anaesthetic cream was reported to be useful for pain relief for cutaneous procedures such as minor surgery and venipuncture.', 'We conducted a prospective, randomized, double-blind, placebo-controlled study comparing the analgesic effect of dexamethasone and placebo in ED patients with periapical abscess during a 2-year timeframe at two urban academic EDs.', 'Patients were randomly divided into two groups: Group S, local wound infiltration with saline solution; Group B, bupivacaine 0.', 'Lidocaine/prilocaine cream under plastic occlusion is the preferred topical anaesthetic during painful laser procedures targeting dermal chromophores.', '120 patients were randomly assigned to one of three groups to receive either saline, lidocaine 20mg, or palonosetron 0.', 'Achillea millefolium and Hypericum perforatum ointments reduce perineal pain level, redness, edema and ecchymosis of episiotomy wound, so it seems that consuming them was useful for episiotomy treatment.', 'In this randomized, double-blind, placebo-controlled clinical trial conducted in a tertiary care hospital, <sup>80</sup>parturients were randomly assigned to two groups of 40 each, to receive either 1000\u2009mg (100\u2009ml) i.v. paracetamol or 100\u2009ml normal saline as placebo, 30\u2009min before the procedure.']


Cluster  1928
['Turkey is one of the countries facing a serious organ shortage problem , with thousands of patients with end-stage organ failure .', 'The lack of effective treatment remains a serious problem in transplantation .', 'Organ shortages are a serious problem , even in the United States .', 'The shortage of human organs for transplantation is a devastating medical problem .', 'In spite of the recent advances in transplantation techniques , donor organ shortage remains a serious problem .', 'The shortage of organ donors is a serious problem in Japan .', 'The shortage of donors has become a serious problem .', 'A shortage of donors poses a serious problem for organ transplantation around the world .', 'Establishing fair allocation priorities is a serious problem in organ transplantation .', 'The small number of organs available for transplant poses a serious problem .', 'The lack of donor grafts is a severe problem in transplantation medicine .', 'However , the imbalance between the supply and the demand for human organs is a serious problem in modern transplantology .']


Cluster  1312
['Thyroid hormones ( THs ) are important for brain development , and polychlorinated biphenyl ( PCB ) accumulation in humans is a serious problem because PCBs may affect TH functions .', 'CH(4 ) has a global warming potential 21 times greater than CO(2 ) ; thus , it poses a serious environmental problem .', 'Contamination of marine environments by hexachlorobenzene ( HCB ) represents a serious concern for potential consequences on ecosystem and human health .', 'The accumulation of chlorophenols ( CPs ) in the environment , due to their wide use as agrochemicals , has become a serious environmental problem .', 'Marine top predators , including marine mammals , are known to bio-accumulate persistent pollutants such as polychlorinated biphenyls ( PCBs ) , a serious conservation concern for these species .', 'Due to extensive use in the past , HCB contamination is still a serious environmental problem .', 'Chlorite is a serious environmental concern , as rising concentrations of this harmful anthropogenic compound have been detected in groundwater , drinking water , and soil .', 'Chromate is considered as a serious environmental problem due its toxicity .', 'Gradual increase in UV-B component reaching earth surface together with heavy metal contamination appears to be a serious environmental concern .']


Cluster  992
['Despite the decreased number of cases among HIV-infected patients over the past decade , Pneumocystis pneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions .', 'As the percent of our population over age 65 increases , infectious disease in this group is becoming a serious public health concern .', 'Invasive pneumococcal disease ( IPD ) is a serious problem in some risk groups : patients with stage 4 and 5 chronic kidney disease , stage 3 CKD undergoing immunosuppressive treatment , nephrotic syndrome or diabetes .', 'Multidrug resistance became a serious concern in the treatment of invasive pneumococcal diseases , especially in Asian countries .', 'Despite modern antibiotic therapies , pneumococcal pneumonia still remains a serious epidemiologic problem .', 'Pneumococcal disease is a serious global public health problem and a leading cause of morbidity and mortality of children and adults in China .', 'Increasing pneumococcal resistance to commonly used antibiotics and multidrug resistance is a serious public health concern .', 'Data confirm that macrolide resistance in pneumococci is a serious problem in many Asian countries .', 'The increasing incidence of macrolide- and tetracycline-resistant pneumococci among children has been a serious problem in China for many years .', 'Invasive pneumococcal diseases ( IPD ) have become a severe problem of public health worldwide .', 'Invasive pneumococcal infections among children are a serious public health problem in many countries , including Turkey .', '[ Penicillin resistant pneumococcus . A serious problem of public health ] .', 'The rate of invasive pneumococcal disease is highest in the very elderly, and manifestations of invasive pneumococcal disease are influenced by age.', 'The rate of invasive pneumococcal disease per 100,000 increased with increasing age.', 'Pneumococcal infection being one of the dominant causes of acute respiratory diseases and exacerbation of chronic ones is a serious problem for human health and society .', 'Pneumococcal infections continue to pose a serious medical problem .']


Cluster  907
['Iatrogenia produced by care systems activity is a serious public health problem and in mental health is poorly understood .', 'In spite of early diagnosis and aggressive treatment , neuropsychiatric SLE may represent a serious problem of management .', 'Psychotic disorders are a serious mental health problem .', 'OSA is as well the risk factor for cardiovascular and metabolic diseases which are a serious clinical problem in mentally ill people and contribute to shortening of their expected lifespan .', 'Water intoxication is a serious problem in many patients with chronic psychiatric illness .', '47 hospital outpatients with PD and no other medical and psychiatric comorbidity and 47 healthy control (HC) subjects were assessed with the Examination of Anomalous Self Experiences (EASE) and Cambridge Depersonalization Scale (CDS).', 'Melanosis observed in association with prolonged chlorpromazine therapy has become a serious problem in mental institutions .', 'Monosymptomatic hypochondriacal psychosis ( MHP ) is a form of psychosis characterized by the delusional idea that there is a serious problem in the skin or other body parts .', 'Although it is a psychiatric disorder , these patients often present to an emergency physician because they are convinced that they have a severe skin problem .', "Psychosis is quite common in Parkinson 's disease ( approximately 25 % of patients ) and therefore constitutes a serious public health problem .", 'We studied 221 patients with PD/PDA recruited to a randomized controlled preference trial of cognitive-behavioral and brief panic-focused psychodynamic psychotherapy.']


Cluster  1677
['The TG showed more significant improvements in MIP (ΔTG:4.', 'Sixty-two MG-assisted TSP attempts were performed; all but two were successfully accomplished without changing to the conventional technique (96.', 'This new technique for TSP using MG is feasible and can be performed with minimal radiation exposure without the need for additional imaging techniques, achieving a significant reduction of fluoroscopy time.', 'We describe a modification that eliminates lagophthalmos , which is the main drawback of the original technique .', 'We propose PDT without curettage as follows: 3\u202fh of MAL incubation and subsequently sufficient illumination.', 'A 5-min intervention using three IASTM techniques can effectively increase the PPT of a MTrP in six treatments over a three-week period of time.']


Cluster  2126
['Thus Wimp will try to believe that . the method encodes strong dependency assumptions between the punctuation symbol to be inserted and its surrounding words', 'Thus Wimp will try to believe that . the method encodes strong dependency assumptions between the punctuation symbol to be inserted and its surrounding words']


Cluster  1531
['Placement instability remains a vexing problem for child welfare agencies across the country .', 'Emotional maltreatment , however , has been slow to achieve recognition as a serious social problem for a variety of reasons .', 'Medically fragile infants were term ( 38 % ) and preterm ( 62 % ) infants who had a life-threatening health problem that necessitated a long hospitalization and dependence on technology for survival .', 'The lack of sufficient day care programs for chronically ill and handicapped children is a serious dilemma for families .', 'At time 1 , being at-risk was reported to be upsetting and fragile X syndrome was perceived to be a serious problem .', 'Global developmental delay is a serious social problem .', "We regard this as a serious deficiency in the current Down 's syndrome risk reporting algorithm , and suggest a modification that allows the problem to be overcome .", 'Although globally the numbers of children diagnosed with failure to thrive ( FTT ) have decreased , FTT is still a serious pediatric problem .']


Cluster  1897
['The basic problem with this method is that the bone graft repair is dependent on the vascular carrier ; the bone needs to be revascularized and regenerate .', 'Large , complex bony defects can be a vexing problem for the reconstructive surgeon , especially when standard donor sites are not available or do not provide sufficient tissue .', 'Large osseous defect remains a serious clinical problem due to the lack of sufficient blood supply and it has been proposed that this situation can be relieved by accelerating the formation of new vessels in the process of bone defect repair .', 'Large-area or critical-sized bone defects pose a serious challenge in orthopedic surgery , as all current treatment options present with shortcomings .', 'Although a free vascularized iliac bone graft has been successfully used for the reconstruction of large bone defects , there is a serious problem of how to repair in one stage patients having a large bone defect with a very wide skin defect .', 'Mouse models are invaluable tools for mechanistic and efficacy studies of the healing process of large bone defects resulting in atrophic nonunions , a severe medical problem and a financial health-care-related burden .', 'However , a drawback of bone healing research is the lack of stable and adaptable fixation devices for small animals .']


Cluster  2352
['Cryotherapy is more effective than IPL in the treatment of hypertrophic scars both on clinical and histopathological level yet with more complications.', 'We conducted a randomized controlled trial to compare the therapeutic efficacy of intralesional triamcinolone acetonide (ILTA) in combination with carbon dioxide laser (Group 1) versus in combination with cryotherapy (Group 2) in the treatment of keloids.', 'Keloids are difficult to treat due to their poor response and high recurrence rate.', 'Cryosurgery is the most commonly used method to treat actinic keratosis (AK).', 'Both CO2 laser and cryotherapy in combination with ILTA were found to be equally effective in the treatment of keloids.', 'Sixty patients with 101 keloids were randomized into 2 groups.']


Cluster  50
['The problem with the scheme is that the area evolution is handled in a manner that violates the basic rules of calculus , which leads to a neglected area evolution term that is equivalent to neglecting a leading-order latent heat flux .', 'How to accurately restore wind-speed patterns is a vexing problem spurring an expanding line of papers .', 'A problem with this approach , however , is that the temperature distribution pattern generated by the inserted electrode varies at any given target region in each heating treatment , which makes it difficult to accurately replicate the heating treatment protocol .', 'A persistent problem in wall-bounded large-eddy simulations ( LES ) with Dirichlet no-slip boundary conditions is that the near-wall streamwise velocity fluctuations are overpredicted , while those in the wall-normal and spanwise directions are underpredicted .', 'Ohmic heating is a serious problem in gradient coil operation .', "Understanding of the different flux responses between the control and local-heating experiments may aid the development of a new index , which helps to avoid LDF 's main drawback of providing only qualitative measurement ."]


Cluster  466
['Optic nerve atrophy seems to be genotype-dependent in MPAN patients but is typical for the disease.', 'Eight eyes exhibited absence of foveal depression on spectral domain optical coherence tomography (Cirrus high-definition OCT; Carl Zeiss Meditec).', 'Adult-onset foveomacular vitelliform dystrophy (AFVD) is a relatively common macular degeneration which might lead to substantial visual loss.', 'To investigate the clinical features in carriers of X-linked retinitis pigmentosa, X-linked ocular albinism, and choroideremia (CHM) using multimodal imaging and to assess their diagnostic value in these three mosaic retinopathies.', 'Our findings in an Asian cohort suggest that FAF imaging is a practical diagnostic test for differentiating X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM carriers.', 'In a retrospective observational study, ophthalmic outcomes were compared between two groups of age-matched patients with genetically and pathologically confirmed PXE: one group with FP versus one without FP.', 'To characterize the appearance of the far peripheral retina of normal eyes using ultra-widefield fluorescein angiography (UWFA).', 'Early poor responders present with more RPE atrophy, as well as a loss of the ELM integrity at baseline optical coherence tomography.', 'All consecutive symptomatic, gene proven MPAN patients underwent a detailed ophthalmological examination: best corrected visual acuity (BCVA), slit lamp examination, dilated fundus examination, tonometry, optical coherent tomography (OCT) and electrophysiological examinations.', 'Normal peripheral retinas generally show granular background fluorescence, with or without a mottled fluorescent band.', 'SPT is a serious problem for the survivors of hereditary retinoblastoma and its importance should be recognized in ( genetic ) counseling of patients .', 'Stellate nonhereditary idiopathic foveomacular retinoschisis can be a devastating problem causing decrease in vision .', 'The plasticity of retinal stem cells (RSCs), a type of cells that can differentiate into neuron cells and photoreceptor cells, endows them with potential therapeutic properties that can be applied to regenerative medicine']


Cluster  404
['Abolished or delayed wound healing is a serious problem in clinical surgery , therefore , the new therapy for wound healing is needed .', 'Diabetes mellitus is a serious public health problem in which a major complication is impaired wound healing .', 'Delayed wound healing is a serious clinical problem in patients after surgery .', 'Wound healing impairment is a serious problem in surgical disciplines which may be associated with chronic morbidity , increased cost and patient discomfort .', 'The clinical results showed that the mean wound healing time of the experimental group was 26 days (P<0.', 'The average baseline wound surface before treatment was 1315\u2009mm<sup>2</sup> in the LED group and 1584\u2009mm<sup>2</sup> in the Co-group (p\u2009=\u20090.', 'The mean wound closure time was significantly lower in the LS group than in the SS group (1.', 'Disorders of wound healing characterized by impaired or delayed re-epithelialization are a serious medical problem .', 'Woundhealing disorders characterized by impaired or delayed re-epithelialization are a serious medical problem that is painful and difficult to treat .', 'Impaired wound healing is a serious concern of uncontrolled hyperglycemia that can lead to gangrene , and even death .', 'After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics.', 'The factors influencing healing are ulcer stage, presence of biofilm, and ulcer depth.', 'Prolonged healing is a severe problem for elderly and diabetic patients .', 'In diabetic patients , impairment of wound healing is a serious problem which represents a significant health burden .']


Cluster  256
['The abuse of drugs such gamma-hydroxybutyrate ( GHB ) has become a serious drug abuse problem in recent years ; however , data on the behavioral effects of GHB are limited .', 'The results showed that either at left or right side, both high and low frequency rTMS are effective in decreasing the cue induced craving to methamphetamine.', 'Oxycodone use disorder ( OUD ) is a serious health problem that has prompted a need to develop animal models of OUD that have both face and predictive validity .', "To enhance discontinuation off-label drug use, staff's feelings should be explored, their knowledge of psychotropic drugs improved and reasons for clinicians' judgements of participants' behavioural worsening investigated.", 'Addiction to psychostimulant drugs such as nicotine , amphetamine , and cocaine is a serious public health problem for which there is a paucity of accepted forms of pharmacotherapy .', 'This study examines the effect of the amount of training on alcohol seeking behavior in rats', 'This is a serious problem in the addiction field , likely to be made worse as new technologies are introduced and/or as there is industry consolidation ( Corredoira , R. , Kimberly , J. ( 2006 ) Industry evolution through consolidation : Implications for addiction treatment .', 'A primary problem with exposure-based interventions for addiction is that after learning not to use substances in the presence of addiction cues inside the clinic ( i.e. , extinction ) , stimuli in the naturalistic setting outside the clinic may continue to elicit craving , drug use , or other maladaptive conditioned responses .', 'The marketing of selective serotonin reuptake inhibitors in the psychopharmacological industry presents a serious moral problem for the corporate model of medicine .', 'Even though its abuse is a serious problem in many countries , there are few safe and effective therapies to treat addiction .', 'In conclusion, bilateral frontal hemispheres are effective in modulating the cue induced craving to methamphetamine with rTMS.']


Cluster  1936
['The excluded infant did not develop signs of NAS, had a low Finnegan score (3 points), and did not present any detectable active psychic ear acupuncture points.', 'To determine the presence of active ear acupuncture points in newborn infants with NAS.', 'The activity of psychic ear acupuncture points may be specific for neonates with NAS.']


Cluster  1182
['Aseptic loosening of tibial components remains a serious problem in uncemented total knee arthroplasties .', 'Aseptic loosening of artificial knee joints induced by wear particles from a tibial polyethylene ( PE ) insert is a serious problem limiting their longevity .', 'Wear debris-induced osteolysis in periprosthetic tissue with aseptic loosening is a serious problem after total joint arthroplasty .', 'Loosening of the implant after total joint arthroplasty remains a serious problem .', 'Loosening is a serious problem in total arthroplasty and early detection of bone loss in the vicinity of an implant would help in its investigation .', 'Aseptic loosening of total hip arthroplasty is still a serious problem .', 'The authors concluded that loosening of the prosthetic components in bone is not a serious problem , but other problems remain .']


Cluster  713
['The EDG technique significantly increased the success rate of biliary duct cannulation within 10 minutes compared with an RSG approach.', 'The Paris Classification improved specificity and accuracy of biliary stricture classification in those who had been previously stented and decreased the rate of misclassification of benign strictures as malignant.', 'On endoscopic ultrasound (EUS)-guided biliary drainage, fistula dilation may be accompanied by leakage of bile juice, potentially along with bacteria or air, so this procedure should be kept as simple and short as possible.', 'Postoperative ascending cholangitis ( AC ) is a serious problem in patients with biliary atresia ( BA ) .', 'cSEMSs were comparable with MPSs regarding post-OLT biliary anastomotic stricture resolution.', 'Our initial results show that duct-to-duct biliary reconstruction using an absorbable internal stent had good patency in all 5 patients.', 'Although additional cases and a randomized controlled comparison with another dilation technique such as the graded dilation or cystotome dilation technique are needed, our technique may be helpful for EUS-guided biliary drainage.', 'Biliary atresia constitutes a serious problem in early infancy , due to the concomitant cholestasis .', 'A cyst of the common bile duct , the most frequent variant of cystic dilatation of the extrahepatic biliary tract , presents a serious diagnostic problem .', 'There are 2 techniques described for selective bile duct guidewire cannulation, the touch (T) technique (engaging the papilla with a sphincterotome and then advancing the guidewire) and the no-touch (NT) technique (engaging the papilla only with the guidewire).', 'Regardless of the application of the present methods , biliary ducts carcinoma remains a serious diagnostic and surgical problem .', 'Our results clearly indicated that the T technique is superior to the NT technique for biliary cannulation.']


Cluster  151
['This is a first study showing significantly a very high prevalence of HPV infection in adolescent and young adult tribal girls possibly due to different socio-sexual behavior , indicating a serious health concern for Indian tribal women .', 'Patients aged ≥4years (n=123) operated on for HD at our center between 1987 and 2011 were invited to answer questionnaires on LUTS and sexual function (aged ≥16years).', "Vaginismus is a severe dysfunction and a problem which can interfere with woman 's and couple 's sex life .", 'Absence of the vagina is a distressing problem .', 'Group\xa0A comprised 254 consecutive MtF transsexuals, who received a\xa0penile inversion vaginoplasty between 2004 and 2010.', 'When South Asian women believe that they have a serious problem of menorrhagia they may not seek medical help because of the shortage of female general practitioners .', 'More women opting for surgery were sexually active ( 51 % versus 29 % , P < 0.0001 ) , perceived avoidance of sex due to prolapse ( 28 % versus 17 % , P = 0.000 ) , and perceived prolapse interfering with sexual satisfaction as a severe problem ( 26 % versus 15 % , P = 0.000 ) .', 'Of the 29 women who underwent labiaplasty, the vast majority reported that they were "moderately" or "extremely" satisfied with the aesthetic (82.', 'On the basis of this study , we can conclude that FGM is a serious clinical problem in Europe for migrant women from risk countries for FGM .', "Previous reports have found the incidence of gender dysphoria in Klinefelter's patients greater than in the general male population"]


Cluster  1396
['Significant embryo loss remains a serious problem in pig production .', 'More teats are necessary for sows to nurse larger litters to provide immunity and nutrient for piglets prior to weaning', 'If perinatal mortality in mice is not recognized and investigated , but instead considered normal when breeding mice , a serious welfare problem might be overlooked .', 'Neonatal deaths are a serious problem in breeding colonies of squirrel monkeys .', 'A serious year-round fertility problem on a commercial piggery was investigated .', 'Neonatal mortality is a severe welfare problem in the pig industry , with the majority of neonatal deaths occurring in those piglets born later in the litter .']


Cluster  102
['Prior to craniotomy for resection of a presumed high-grade glioma, individuals were given oral 5-ALA as part of a rapid dose-escalation scheme.', 'Adults having elective brain tumor excisions under balanced general anesthesia with endotracheal intubation were randomized to an infusion of remifentanil (0.', 'In a cohort of patients from a national prospective surgical registry, increased operative duration was associated with increased incidence of VTE for neurosurgical procedures.', 'We performed a retrospective cohort study involving patients who underwent neurosurgical procedures from 2005 to 2012 and were registered in the American College of Surgeons National Quality Improvement Project registry.', 'Intraoperative awake testing for treatment efficacy may increase the success rate of MVD by rapidly identifying and mitigating insufficient cranial nerve V decompression.', 'Thirteen patients with intraparenchymal brain metastases were administered indocyanine green (ICG) at 5 mg/kg the day before surgery.', 'A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy.', 'We studied 16 patients who underwent CP after decompressive craniectomy (DC) for traumatic brain injury.', 'This is a retrospective, observational study of patients who underwent craniotomy for primary brain tumor resection at a single tertiary care hospital between January 2005 and October 2017.', 'The use of 5 mL/kg of equiosmolar solutions of 3% HS and 20% mannitol applied to reach a brain relaxation during elective craniotomy does not induce coagulation impairment as evidenced by ROTEM and standard coagulation tests.', 'To investigate the association of surgical duration for several neurosurgical procedures and the incidence of VTE.', 'The "floating anchored" craniotomy is a technique utilized at our tertiary neurosurgery institution in which a traditional decompressive craniectomy has been substituted for a floating craniotomy', 'In a prospective, randomized, double-blind trial, 40 patients undergoing elective craniotomy were randomized to receive 5 mL/kg of either 20% mannitol or 3% HS for intraoperative brain relaxation.']


Cluster  1201
['Continuous glucose monitoring system (CGMS), used as the reference method, was compared with the OGTT, intravenous glucose tolerance test (IGTT), homeostasis model assessment index of insulin resistance (HOMA-IR), homeostasis model assessment index of β-cell function (HOMA-%B) and glycated haemoglobin A1C.', 'Treatment with GesTIO protocol allows a safe and effective treatment even in very old and vulnerable inpatients with a faster management insulin therapy.', 'Short-term prophylactic use of haloperidol was not associated with changes in glucose levels in older hospitalized patients compared with those given a placebo in this small study.', 'The trial shows that higher blood glucose variability was correlated with higher incidence of periprocedural myocardial infarction and MACE at 6months follow-up.', 'Forty-three patients underwent PT for type 1 diabetes mellitus at our institution from August 2001 to May 2016.', 'Forty patients undergoing OPCABG were randomly divided into SM group (n\u200a=\u200a20) and the 5% glucose (G) group (n\u200a=\u200a20).', 'The councils determined that the main barriers to optimal care of community-based patients with NIDDM are that 1 ) NIDDM is not considered or managed as a serious problem by most physicians and their patients ; 2 ) the genetic basis for and refractory nature of obesity are not generally appreciated ; and 3 ) as a complex , multisystemic chronic illness , diabetes fits poorly in a health care delivery system designed to deal with acute and episodic illnesses .', 'Retrospective analysis over a 6-year period (2010-2015) in Piedmont and Aosta Valley regions (5,305,940 inhabitants, 141,174 diabetics treated with metformin) of all MALA-RRT cases.', 'Patients in the initial-treatment group had lower serum albumin concentration, less diabetes, and were younger.', 'The FGMS can be used for future studies of PPH and circadian fluctuations of glucose concentrations in dogs with DM in their home environment.', 'While the prevention of acute metabolic decompensation is no longer a serious problem in treating patients with non-insulin-dependent diabetes mellitus ( NIDDM ) , target organ complications can have serious consequences , including blindness , renal failure , neuropathy , amputation , coronary artery disease , and stroke .', 'Changes in βCGS and insulin sensitivity were inversely associated with changes in Glu120 at follow-up, contributing a likely explanation for the reversal of IGT to NGT.']


Cluster  2282
['Forty patients with cataract, scheduled for operation under general anesthesia, were randomly allocated into two groups.', 'The intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions.', 'Despite recent innovations in cataract surgery, pupillary diameter is one of the most important affecting factors in outcome of this surgery.', 'Single centre prospective observational cohort study of consecutive patients undergoing elective cataract surgery in the United Kingdom over a 3 month period from May to August 2020.']


Cluster  190
['<i>In vitro</i> dissolution to study impact of alcohol and pH on Chronocort.', 'A serious drawback of arene diazonium salts is their instability in a dry state ; therefore , they must be stored and handled carefully to avoid spontaneous explosion and other hazard events .', 'Results support the initial hypothesis that systemic exposure of poorly soluble inhaled drugs is a complex but predictable function of dose, deposition pattern, and rate of dissolution.', 'This could be a serious problem for drugs , which are absorbed from these sites of the GIT .', '<i>In vitro</i> dissolution of Chronocort was not affected by gastrointestinal pH up to 6.', 'Ingestion of a chemical agent is a serious problem , and several treatment protocols to prevent stricture formation have been proposed .', 'Compromised stability of pharmaceutical formulations loaded with volatiles is a serious problem associated with devices designed to deliver volatile compounds .', 'The sensitivity of drugs to one or more elements of the primary packaging is a serious concern for the pharmaceutical industry .', 'The charge interaction resulted in the retention of metformin in croscarmellose sodium and caused a serious drug recovery problem .']


Cluster  913
['EBUS-TBNA revealed a specific cause for suspected non-malignant lymphadenopathy in one-third of cases and was associated with excellent specificity.', 'We describe the clinicopathological and immunohistochemical findings of nine cases of autoimmune disease-associated lymphadenopathy , which posed a serious differential diagnostic problem regarding T-zone dysplasia with hyperplastic follicles .', 'In the methylene blue group, 678 lymph nodes were harvested by simple palpation and sight.', 'Fifty-six lymph nodes were analyzed.', 'These results report lymphatic drainage from patients with normal splenic flexures, and caution is necessary when extrapolating to patients with splenic flexure cancers.', 'A Severe Case of Anaplastic Large Cell Lymphoma in a Previously Healthy Woman : Diagnostic and Therapeutic Challenges .', 'Of 172 biopsy-proven PCBCL lesions, cutaneous lymphoma was suspected by the clinician in 16.', 'Baseline lymphoscintigraphy showed abnormality in lower limb lymphatics in 80% of symptomatic (40/50) and 63·5% (33/52) of asymptomatic children.', 'The authors\' findings show wide differences and an often "slow" tracer appearance time in patients with intact lymphatic system, questioning the use of contralateral limb as control and transportation time greater than 30 minutes as criteria for identification of lymphatic alterations.', 'During study period, 333 EBUS bronchoscopies in 315 patients with mediastinal lymphadenopathy were performed.']


Cluster  75
['In the case of Japanese text processing , the most serious problem is poor accuracy of word segmentation and POS tagging', 'A major drawback of inducing normalization lexicons using most approaches described in Section 2 is that they are restricted to learning one-to-one word mappings', 'We propose extending the lattice-based approach to jointly perform lexical normalization , word segmentation , and POS tagging . it tends to be costly in terms of time and bandwidth', 'The normalization module is responsible for normalizing and tagging the texts . when two entities belonging to the same class are adjacent , our classifier will automatically merge them into one entity', 'A difficulty in comparing approaches to tweet normalization is the sparsity of publicly available datasets', 'The above discussion is overly simplified for the purpose of explanation . poor accuracy of word segmentation and POS tagging', 'The normalization module is responsible for normalizing and tagging the texts . when two entities belonging to the same class are adjacent , our classifier will automatically merge them into one entity', 'We propose extending the lattice-based approach to jointly perform lexical normalization , word segmentation , and POS tagging . it tends to be costly in terms of time and bandwidth']


Cluster  1827
['Retrospective, observational study.', 'Retrospective observational cross-sectional study of prospectively collected data.', 'Retrospective observational study.', 'This was a retrospective observational study.', 'A retrospective observational study.', 'This was a retrospective, observational study.', 'This was a retrospective study.', 'Retrospective observational study.', 'This is a retrospective study.', 'This study is an observational retrospective study.', 'Observational analysis of retrospectively collected data.', 'A longitudinal observation.', 'This is a retrospective, observational study.', 'This was a retrospective, observational, analytical study.']


Cluster  2179
['Blood culture reports were positive in 322 (37.', 'We evaluated 393 cases with positive test results, including 98 cases with severe symptoms.', 'Proteins (n\u2009=\u2009113) detected in more than 90% patients were considered representative.', 'Samples of TLCB allowed the diagnosis of 75.', 'We carried out in vivo tests (skin prick) and in vitro tests (specific IgE determination, Western blot) and component resolved diagnostics (CRD) using microarray analysis in all patients.', 'D. folliculorum was positive in 53.']


Cluster  261
['We tested all three feature types , and found the biggest gain with the domain indicator feature -LRB- +.11 , Table 4 -RRB- . tree overgeneration', 'We train the MaxEnt classifier using semisupervised learning . the representation consumes more storage space than necessary', 'Phrases 5 and 6 must be made to have the same feature structure , but this appears to entail assigning two different values to the feature structure for walked . they are not capable of coming to grips with the pervasive fuzziness of information in the knowledge base , and , as a result , are mostly ad hoc in nature', 'In Section 5 we suggested that mixed dependencies may be the result of distance . is not feasible to search the space of possible feature sets by hand', 'The model also has the ability to learn the number of basis vectors required to represent the principal directions of each cluster , so it overcomes a drawback of most local PCA models , where the dimensionality of a cluster must be fixed a priori .', 'A common problem with all SR-based biological data classification methods is that they can not utilize the topological ( geometrical ) structure of data .', 'In Section 5 we suggested that mixed dependencies may be the result of distance . is not feasible to search the space of possible feature sets by hand', 'But drawback noticed in this approach is that such techniques cannot be extended with semantically analyzed structures for target identification', 'Thus probabilistic modeling of any data structures is possible when they are represented by feature forests . unobserved co-occurrences of words in the training corpus', 'Similar to SVM , with a linear kernel function , other non-feature selective LDA and NN classifiers also show a slight improvement in performance using twice the features but with the drawback of increased memory space requirement and time .', 'Decision trees [ 2 ] can handle complex condition , but they have a limitation in consuming very large parameter spaces', 'Thus probabilistic modeling of any data structures is possible when they are represented by feature forests . unobserved co-occurrences of words in the training corpus', 'This has the potential drawback of increasing the number of features , which can make MERT less stable ( Foster and Kuhn , 2009 )', 'Leveraging a random feature ( RF ) approximation , the major drawback of OMKL , known as the curse of dimensionality , has been recently alleviated .', 'The difference between our method and Birch et al. . scores -- and as a result any feature representations -- are restricted to a single arc or a small number of arcs in the graph', 'Therefore , this parameter can be used to adjust the balance between precision and recall . it can miss the kind of conditioning information present in local subtrees']


Cluster  948
['This was an observational retrospective study that included 737 patients who were diagnosed with palmar or axillary hyperhidrosis and received VATS from January 2007 to January 2014.', "Plantar hyperhidrosis is a distressing problem that can affect a patient 's quality of life .", 'An otherwise successfully performed endoscopic thoracic sympathectomy (ETS) to treat palmar hyperhidrosis (PH) often has a serious side effect: compensatory sweating (CS).', "Axillary bromhidrosis is a distressing problem , which has a strong negative effect on one 's social life .", 'This 2-week, double-blind, randomized, vehicle-controlled study evaluated systemic exposure, safety and tolerability of topically administered UMEC in subjects with primary axillary hyperhidrosis.', 'Sweating can be a distressing and difficult problem to manage in patients with advanced cancer .', 'Hyperhidrosis is a debilitating problem that is not only uncomfortable and inconvenient , but also embarrassing in work and social situations .', 'Botulinum type A toxin seems to be a safe secondary treatment option for plantar hyperhidrosis in adolescents aged 12 and older.']


Cluster  1518
['Palmar telangiectasias were found to be associated with current or past smoking.', 'We conclude that telangiectases occur at an earlier age than generally thought and are a hallmark of a serious disorder rather than a cosmetic problem .', 'Pigmentation is one of the essential defense mechanisms against oxidative stress or UV irradiation ; however , abnormal hyperpigmentation in human skin may pose a serious aesthetic problem .', 'Hyperpigmentation disorders are a serious aesthetic problem .', 'Partial unilateral lentiginosis (PUL) is a rare acquired circumscribed hyperpigmentation characterized by multiple simple lentigines involving half of the body']


Cluster  1380
['A prospective study was conducted amongst third-year medical students using a 20-item survey.', 'Forty surgical novices (pre-clerkship-level medical students) voluntarily participated in this trial.', 'Nineteen general surgery residents were block randomized by postgraduate year level to a didactic or a simulation session.', 'A randomized three-period crossover trial was conducted, in which seven surgical residents and 13 medical students participated.', 'Fifty junior anesthesiology residents were randomized to one of the three simulation cohorts.', 'We conducted a randomised controlled study on 34 third-year undergraduate medical students in the academic year 2015-2016.', 'Cluster randomised study of 38 fifth-year medical students during a 16-week clinical placement.']


Cluster  1467
['Rare diseases , despite the low frequency of occurrence , together cover a large group of diseases being a serious medical , social and economic problem .', '[ Rare diseases : inadequeate data for a serious problem ] .', 'Rare diseases are a serious public health concern and are a priority in the EU .', 'Rare diseases are a serious public health problem and are a threat to the health of EU citizens .']


Cluster  491
['The problem with this is that disciplinary law assumes individual liability .', 'A significant drawback of the Dutch policy , however , is that employers refrain from employing persons with a high risk of falling ill .', 'But side by side with the presumed benefits of policy , many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources .', 'One problem with work , however , was that ( at least initially ) it did not attempt to distinguish between individuals or groups of people , except " experts " vs. " lay people . " This paradigm produced a " cognitive map " of hazards , and the assumption seemed to be that the characteristics identified were inherent attributes of risk .', "Norman Daniels ' theory of justice and health faces a serious practical problem : his theory can ground the special moral importance of health and allows distinguishing just from unjust health inequalities , but it provides little practical guidance for allocating resources when they are especially scarce .", "The major problem with developing health policy through the courts is that the courts ' focus will be the concerns of the individuals or groups involved in specific cases , not the broader implications and overall objectives of the health care system .", "The biggest problem with the Missouri Supreme Court 's decision was that it gave absolute precedence to the state 's interest in preserving life , excluding quality-of-life considerations and disregarding personal , familial , and professional values that should have affected the decision .", 'A problem with this approach , however , is that the labor components of the typical health care provider are no longer atypical .']


Cluster  225
['The development of a new class of carbon electrocatalysts for nitrate reduction reaction ( NRR ) that have high activity and durability is extremely important , as currently reported metallic electrocatalysts show a main drawback of low stability owing to leaching and oxidation .', 'Metal ion contamination of water , especially with toxic metals such as nickel(II ) [ Ni(II ) ] , which is extensively applied in the electroplating industry , has been a serious problem .', 'In the last decade , adsorption has been used to minimize the pollution caused by dyes , which represents a serious environmental problem .', 'Removal of contaminants in wastewater , such as heavy metals , has become a severe problem in the world .', 'Photo-Fenton was found to be the more appropriate treatment for these compounds , assuming volatilisation as a drawback of photocatalytic degradation of NBCS dissolved in water .', 'The deactivation of selective catalytic reduction ( SCR ) catalysts by arsenic is a serious problem for NH', 'Water contamination by toxic heavy metal ions and dyes remains a serious public health problem for humans , so attention on specific methods and technologies to remove heavy metal ions and dyes from wastewaters/aqueous solutions are desired .', 'Halogenations of polycyclic aromatic hydrocarbons ( PAHs ) comprise a serious problem , when electrochemical oxidation ( EO ) is applied for treatment of chloride and bromide containing polluted sea water .', 'Activated carbon ( AC ) is the most commonly used adsorbent for water purification , although the dispersive nature of AC in aqueous solution poses a serious problem .', 'Environmental contamination by Te and Se oxyanions has become a serious concern , with the search for green , ecologically friendly methods for removal gaining ground .']


Cluster  927
['Adherence appears to be a serious problem among HIV-positive adolescents .', 'Among non-HIV-infected patients , about half have a serious underlying medical problem , most commonly diabetes mellitus , malignancy , or a rheumatologic condition .', 'Contamination by HIV present at undetectable levels at the time of testing is a serious problem .', 'We prospectively studied clinical presentation, diagnosis and outcome of febrile episodes in a contemporary cohort of HIV-patients with good access to antiretroviral therapy.', 'Infection with the human immunodeficiency virus ( HIV ) in the adolescent/young adult population of the United States is a serious , growing problem .', 'HIV infection is still a serious medical problem in CF .', 'Dolutegravir plus an optimized background regimen seemed safe, well tolerated, and efficacious in this cohort of treatment-experienced HIV-1-infected adolescents.', 'In this pilot randomized, double-blinded, placebo-controlled, clinical trial, 51 HIV-positive patients who were receiving efavirenz were recruited into the valerian (n = 25) or placebo (n = 26) group.', 'For people living with HIV , lack of adherence to antiretroviral therapy ( ART ) is a serious problem and frequently results in HIV disease progression .', 'The rheumatological complications in HIV positive patients are rather common and are recognized as a serious problem that requires more attention .', 'Depression can be a serious problem for HIV infected .', 'Late diagnosis of human immunodeficiency virus ( HIV ) is associated with increased morbidity and mortality , and represents a serious public health concern .', 'The study enrolled human immunodeficiency virus type 1 (HIV-1)-infected treatment-experienced adolescents aged 12 to <18 years, with an HIV-1 RNA level ≥1000 copies/mL .', 'Since HIV has evolved from being a fatal illness to a chronic condition , this brings new challenges relating to long-term health , as increasing numbers of people living with HIV ( PLHIV ) navigate their lives beyond viral suppression .', 'With the realization that individuals with human immunodeficiency virus ( HIV ) infection often have elevated CVD risk factors , the evaluation of CVD risk for these individuals becomes a serious concern .', 'HIV-patients with access to antiretroviral therapy present with fever mostly due to conditions common in the general population.', 'Nonadherence to HIV medications is a serious unsolved problem and is a major cause of morbidity and mortality in the HIV-positive population .', 'A major problem with previously utilized activating agents is that at the concentrations required for efficient HIV-1 reactivation , these stimuli trigger high-level cytokine gene expression ( hypercytokinemia ) .', 'Mental health of HIV-infected patients : A severe , but Overlooked Problem .']


Cluster  654
['ICU-acquired infections are a serious problem .', 'The increasing emergence and spread of multiresistant microorganisms in hospital wards is a serious concern .', 'Healthcare-associated infections ( HAIs ) are a serious problem of modern medicine .', 'Hospital acquired infections ( HAIs ) are a serious problem that potentially affects millions of patients whenever in contact with hospital settings .', 'Healthcare-associated infections ( HAI ) are a serious patient safety problem .', 'Hospital-acquired infections can cause serious complications and are a severe problem because of the increased emergence of antibiotic-resistant bacteria .', 'Healthcare associated infections ( HAIs ) represent a serious problem for public health , as they increase the morbidity and mortality rates , present a relevant financial burden , and significantly contribute to the antimicrobial resistance .', "Multiresistant hospital-acquired bacteria should be viewed as a serious public health issue rather than an individual hospital 's problem .", 'Hospital infections are a serious epidemiological problem since hospital departments have been established .', 'Presence of multiple drug resistant pathogens in hospital waste is a serious public health concern , because it may ultimately be disseminated to the human .', 'Healthcare-associated infections ( HAIs ) in critically ill patients are a serious public health problem .', 'A serious drawback of DDS is the risk of favoring the selection of resistant microorganisms that can spread easily through the ICU and the hospital .', 'Occupational infections particularly hospital-acquired infections ( HAIs ) are a serious problem in the healthcare industry worldwide .']


Cluster  2250
['PRACTICAL APPLICATION : Coffee adulteration is a serious problem in the food chain as some fraudsters replace coffee powder by other cheaper products .', 'Adulteration of foods is a serious economic problem concerning most foodstuffs , and in particular meat products .', 'Food adulteration is a serious social problem all over the world .']


Cluster  889
['Proliferative vitreoretinopathy ( PVR ) is a serious problem in vitreoretinal surgeries .', 'Deep sclerectomy decreases IOP and increases OPP significantly.', 'Although recovery of visual acuity is seen in a minority of cases , visual loss after ROSO remains a serious and unexplained concern for vitreoretinal surgeons .', 'Preoperative myopic spherical refraction and ablation depths were similar in the study and control groups.', 'Our study demonstrates that phacoemulsification whether done with a clear temporal or clear superior wound, does not affect intraocular pressure, bleb morphology or function after one year of follow-up in eyes following previous successful trabeculectomy.', 'To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD.', 'This is a prospective interventional comparative study conducted on 40 eyes (20 patients) with medically uncontrolled JOAG, randomly operating one eye for trabeculectomy with ologen (group A: 20 eyes) and the other with MMC (group B: 20 eyes).', 'A return toward toward photorefractive keratectomy has occurred due to better corneal stability and fewer corneal flap complications ; however , pain remains a major drawback of the procedure .', 'Sixty patients (60 eyes) underwent photorefractive keratectomy for myopia.', 'To evaluate the healing course of conjunctival wounds in eyes undergoing 23-gauge sutureless vitrectomy and to determine when the potential for ocular surface fluid contamination is no longer a serious concern .', 'Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears.', 'A prospective case series is reported, in which the decision that influenced the use of the optical coherence tomography imaging during pars plana vitrectomy is evaluated.', 'To analyse visual outcomes and corneal changes 3\u2005years after intrastromal femtosecond laser presbyopia treatment.', 'To investigate the effect of deep sclerectomy on retrobulbar blood flow.']


Cluster  429
['Opisthorchis viverrini is still a serious problem in rural areas of Thailand particularly Northeastern and Northern region .', 'Liver fluke infection with Opisthorchis viverrini and its associated cholangiocarcinoma constitute a serious problem in Thailand .', 'Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia .', 'Despite a long research history going back to 1927 , opisthorchiasis remains a serious problem in Russia , and numerous questions related to the epidemiology of these liver fluke infections and their patterns of distribution in Western Siberia , the causes of high prevalence in different populations , and the prognosis of the epidemiological situation remain to be answered .', 'Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia especially in Lao PDR and Thailand .', 'Opisthorchiasis caused by Opisthorchis viverrini infection , is a serious public health problem in Lao PDR , Cambodia , Vietnam and Thailand .', 'Opisthorchis viverrini is still a serious problem in Northeastern and Northern Thailand .', 'Opisthorchis viverrini infection is a serious public health problem in Southeast Asia especially in the northeast and north of Thailand .', 'In Thailand , infection with the liver fluke Opisthorchis viverrini is a serious health problem , with over 8.6 million human infections each year .', 'Infection with Opisthorchis viverrini appears to be a serious public health problem strongly associated with the frequent eating habit of raw fish in low land Laos .', "Opisthorchis viverrini is a serious problem in Thailand , Cambodia , the Lao People 's Democratic Republic and Vietnam .", 'Infection with the human liver fluke , Opisthorchis viverrini , is a serious public health problem in Thailand , Laos and nearby locations in Southeast Asia .', 'The liver fluke Opisthorchis viverrini is a serious health problem in Thailand .']


Cluster  626
["Although high-dose chemotherapy with autologous peripheral blood stem cell transplantation ( autoPBSCT ) has been shown or confirmed to be an effective treatment for high-risk and relapsed non-Hodgkin 's lymphoma ( NHL ) , relapse after autoPBSCT remains a serious problem .", 'Relapses after autologous transplantation are a serious clinical problem in patients with haematological diseases .', 'De-novo malignancies continue to be a serious problem after kidney transplantation .', 'Observational prospective study of all transplants performed in our center in 2012-2013 followed to 2016.', 'Of the 134 patients who underwent RHC as part of the initial transplant evaluation, 50 patients were successfully transplanted.', 'Tumor relapses remain a serious problem after allogeneic stem cell transplantation ( alloSCT ) , despite the long-term persistence of minor histocompatibility antigen (MiHA)-specific memory CD8(+ ) T cells specific for the tumor .', 'However , the recurrence of HCC after transplantation remains a serious problem that affects about 20 % of post-transplant cases .', 'A vexing problem after hematopoietic cell transplantation ( HCT ) for leukemia is assessing the biologic significance of low numbers of cells " suspicious " for relapse seen in morphologic review of peripheral blood smears ( PBSs ) .', 'This was a retrospective observational case-control study including patients who received transplants in our hospital from 2003 to 2009 with a follow-up period to 2015.', 'De novo malignancies following renal transplantation represent a serious problem endangering the prognosis of otherwise successfully transplanted patients .', 'Despite unequivocal success , relapse after transplant remains a serious problem , being the main cause of treatment failure .']


Cluster  963
['Tuberculosis ( TB ) remains a serious public health problem in South Africa .', 'Tuberculosis remains a severe public health problem , and is a major cause of infant disease in North Lebanon .', 'This review indicated that MDR-TB in Ethiopia is a serious public health problem that needs to be addressed urgently .', 'Tuberculosis remains a serious public health problem in South Africa .', 'We conclude that emergence of drug resistant tuberculosis has the potential to be a serious public health problem in Sudan and that strengthened tuberculosis control and improved monitoring of therapy is needed .', 'The prevalence and distribution of drug-resistant TB remains a serious public health problem in Ethiopia .', 'Tuberculosis ( TB ) control in Georgia follows the World Health Organization-recommended DOTS strategy , and has reached global TB control targets in the treatment of susceptible TB ; however , the management of drug-resistant forms of TB still represents a serious problem .', 'In Africa , tuberculosis affects over 200 cases per 100,000 persons , and more than 22 million people live with HIV infection ; both diseases are a serious public health problem .', 'Tuberculosis ( TB ) poses a serious public health problem in Angola .', 'TB disease is still present in Lebanon with fluctuating level with the highest peak found in 2013 explained by the influx of Syrian refugee population.', 'Tuberculosis ( TB ) has emerged as a serious public health problem in the country of Georgia .', 'Tuberculosis in refugee centres is a serious problem that needs adequate attention .', "In Côte d'Ivoire , multidrug-resistant tuberculosis ( MDR-TB ) is a serious public health problem with a prevalence estimated at 2.5 % in 2006 .", "Nigeria has the world 's fourth largest tuberculosis burden , and multidrug resistant tuberculosis ( MDR-TB ) represents a serious public health problem ."]


Cluster  564
['In AS rehabilitation, performing balance and stability exercises in addition to spa based routine approaches can increase the duration of maintaining balance and can improve the benefits of physiotherapy.', 'Rehabilitation has proven effective in improving motor symptoms (i.e., weakness, tremor, gait and balance disorders) in patients with Functional Motor Disorders (FMDs).', 'A larger reduction in disability was observed for subjects treated with core stabilization exercises in comparison to those treated with routine physical therapy.', 'The results suggested that a gait training program based on HAL® may improve independent walking more efficiently than CGT at 1 and 2 months after intervention.', 'The findings suggest that novel FES therapy combined with conventional rehabilitation is more effective on walking speed, mobility of the lower extremity, balance disability and activities of daily living compared to a conventional rehabilitation program only.', 'The aim of this study was to analyse the effect of 10-week core stability training (CST) program on balance in women with relapsing-remitting MS according to EDSS Score.', 'A 10-session treatment with GRAIL on children with ABI led to improvements in their walking abilities and enhanced their engagement during the training.', 'The aim of this study was to investigate the effects of balance and postural stability exercises on spa based rehabilitation programme in AS subjects.']


Cluster  1123
['To assess CST impairment in MS patients with and without spasticity and to evaluate its evolution under Sativex<sup>®</sup> treatment.', 'As a result, patients with MS have seen similar benefits in Reformer Pilates and Mat Pilates methods.', 'Spasticity is a serious problem in multiple sclerosis ( MS ) and many patients do not achieve a satisfactory response to currently available oral antispasticity drugs .', 'An acute bout of moderate-intensity treadmill walking exercise has previously been associated with improvements in overall mood disturbance and vigor, without worsening fatigue, among persons with multiple sclerosis (MS).', 'RAGT improved the walking competencies in non-autonomous ambulant patients with MS, with benefits in terms of perceived fatigue.', '41clinically definite MS subjects with upper limb impairment were randomised into two groups: (i) Haptic and (ii) Sensorimotor.', 'To investigate the effect of motor imagery combined with rhythmic cueing on walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS).', 'Considering the effectiveness of LT and ACT in reducing DA in MS patients, the results of this study can be used in order to achieve therapeutic goals and reduce psychological problems in chronic diseases.', 'To compare the effect of robot-assisted gait training (RAGT) with that of conventional walking training (CWT) on gait competencies, global ability, fatigue and spasticity in a group of severely affected patients with MS.', 'We designed a study of acupuncture treatment, according to the Heidelberg model of Traditional Chinese Medicine (TCM), to investigate if acupuncture can be a useful therapeutic strategy in patients with gait impairment in multiple sclerosis of relapsing-remitting type.', 'People with MS (n\u202f=\u202f20, EDSS range 4-8) were divided into three groups, receiving task-oriented training at 100% (n\u202f=\u202f7) or 50% (n\u202f=\u202f8) of their individual maximal number of repetitions, or conventional occupational therapy (n\u202f=\u202f5).', 'Our findings show a short-term beneficial effect of motor rehabilitation on gait performances in MS, accompanied by brain functional reorganization in the sensory-motor network.', 'Task oriented training may improve upper limb function in persons with MS especially in prevalent pyramidal impaired subjects without maintain the effects after three months.', 'Direct referral to physical activity from a physician is twice as effective as simply providing information about physical activity for adherence to the PAG in people with MS.', 'To examine the effectiveness of a Vojta locomotion reflex program as short-term automatic postural control in patients with Multiple sclerosis.', 'Cognitive impairment ( CI ) in Multiple Sclerosis ( MS ) has progressively regained clinical and research interest and is currently recognized as a debilitating and burdensome problem for these patients .', 'We previously demonstrated that gait variability increases throughout the disease process in people with multiple sclerosis (PwMS).']


Cluster  576
['Despite the wide use of PCV2 vaccination , PRDC remains a serious respiratory problem .', 'These preclinical results suggest that PCV7-TT will not result in a serious problem over the immune response elicited by the licensed vaccines Heberpenta ® -L and VA-MENGOC-BC ® .', 'Severe local swelling has been regarded as a serious safety problem for the booster immunisations of diphtheria tetanus acellular pertussis combined ( DTaP ) vaccine and DT combined toxoids ( DT-td ) .', 'Use of antimicrobials and TTPs reduced after PCV10 was introduced into a routine vaccination program.', 'A significant rise in postbooster BMEM frequency was seen for 5 out of 6 serotypes in the PCV-13 group and none in the PCV-10 group.', 'Postvaccination syncope can cause injury.', 'In Central Greece during the first five years of high coverage with PCV13, serotype 3 was the only PCV13 serotype that clearly persisted in children with empyema.', 'After priming with PCV-13 in early infancy, a booster dose of PCV-10 does not induce detectable peripheral blood BMEM responses but a PCV-13 booster does induce robust responses.']


Cluster  1975
["This was a retrospective observational study of term neonates who received phototherapy in the mother's room.", 'We tested whether direct transcutaneous bilirubin (TcB) measurement from an area unexposed to phototherapy is reliable for estimation of total serum bilirubin (TSB) in neonates during phototherapy and whether it contributes to reduction in TSB blood sampling in phototherapy decision making.', 'The predictive utility of TcB as a potential screening tool varies across devices in black African neonates with or without risk of significant hyperbilirubinemia, and lower than levels reported in non-black populations.', 'A retrospective analysis of 12,377 TcB measurements obtained from 6,373 neonates in the first postnatal week, over a period of 48 months using Bilichek and JM-103 bilirubinometers.', 'Direct measurement of TcB during phototherapy using a bed-type device is a reliable method to estimate TSB in term neonates and would contribute to a reduction in blood sampling.']


Cluster  1515
['To explore the effects of DN on wrist flexors spasticity poststroke.', 'A transversal and descriptive study on 54 patients with spastic tetraparesis was held.', 'Spasm was observed in more than 45% of the individuals and the intensity of muscle activation was increased by more than 78% in the relaxation phase.', 'Spasticity is a serious problem that adversely affects the daily life of patients , and creates difficulties for caregivers .', 'The results of this study indicate that progressive muscle relaxation can increase adaptation to old age and the quality of life and of older people in a nursing home.', 'This study suggests that DN reduced wrist flexors spasticity and alpha motor neuron excitability in patients with stroke, and improvements persisted for one hour after DN.']


Cluster  719
['Over recent years C. difficile diarrhea has become a serious problem in geriatric units .', 'Intestinal infections caused by the Clostridium difficile ( CDI ) bacterium currently represent a serious medical problem .', 'Clostridium difficile is a serious epidemiological problem and particularly dangerous microorganism causing hospital infections .', 'Infectious diarrheal diseases can be a serious problem in long-term care institutions .', 'Recurrence of Clostridium difficile-associated diarrhea ( CDAD ) is a serious and still unsolved problem .', 'This study suggests that a saline enema for the mother during the first stage of labour may be useful in reducing the risk of neonatal gut colonization by C.\xa0difficile.', '[i]Clostridium difficile[/i ] infections become a serious problem in terms of nosocomial infections , as well as a consequence of common use of antibiotics .', 'C. difficile infection is low in Greek intensive care units , but remains a serious problem among the critically-ill .', 'Among the various infectious diseases , Clostridium difficile infection is associated with a high rate of mortality in elderly individuals and is a serious health problem worldwide , owing to the increasing infection rates .']


Cluster  526
['However , they are recognized as one of the most common food allergens and pose a serious health problem in countries where fish consumption is high .', '  Childhood shellfish allergy is a serious and underdiagnosed problem in the United States .', 'A serious toxicological problem affecting many countries of the world , mild cases of this poisoning can occur within 30 minutes while in extreme cases , death through respiratory paralysis may occur within 2 - 24 hrs of ingestion of intoxicated shellfish .', 'Paralytic shellfish poisoning is a serious public health concern throughout the world .', 'Diarrheic Shellfish Poisoning toxins ( DST ) are a severe health risk to shellfish consumers and can be a major problem for the shellfish industry .', 'To assess IgE hypersensitivity caused by fish parasite allergens in patients with gastro-allergic symptoms after consumption of fish, shellfish or cephalopods, compared with healthy subjects, pollen allergic individuals and children with digestive symptoms after eating marine food.', 'Food allergies represent a serious public health problem worldwide with fish being one of the top eight more allergenic foods .', 'The hazard to intoxication is not as common in purchased seafood , which is more stringently regulated , yet still is a serious problem .']


Cluster  699
['In this cohort of patients with liver cirrhosis and no manifest HE, the CRT identified a group in whom cognition improved with intensive anti-HE intervention.', 'Patients with cirrhosis are reportedly more prone to develop hemorrhagic stroke, thereby increasing the risk of death.', 'Hepatic encephalopathy is a serious problem in patients with liver cirrhosis and precise pathophysiological mechanisms responsible for encephalopathy are not fully understood .', 'Of the 2444 patients with liver cirrhosis, 160 had ischemic stroke, including 128 patients with previous ischemic stroke and 32 patients with new-onset ischemic stroke during their hospitalizations.', 'Ischemic stroke was often observed in patients with cirrhosis, and it significantly increased the in-hospital mortality.', 'To examine if the continuous reaction time test (CRT) can detect changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE).', 'Subclinical hepatic encephalopathy ( SHE ) is a serious clinical problem in patiens with liver damage and precise pathophisiological mechanisms resonsible for encephalopathy are not fully understood .']


Cluster  345
['On a world-wide basis , the tuberculosis ( TB ) represents a serious public health problem , existing great differences between developed and developing countries in terms of controlling the disease .', 'The developing world is facing a serious problem of tuberculosis ( TB ) since ages .', 'Malnutrition is a serious problem among TB patients in peri-urban areas of Dhaka City .', 'On the occasion of the commemoration of the 100th anniversary of the discovery of the tubercle bacillus by Robert Koch , in 1982 , it could be stated that in GDR , like in other developed countries , tuberculosis is not any more a serious problem of public health but has changed to a much reduced endemic disease .', 'High incidence rates and increasing time trend of tuberculosis in the elderly in Central Serbia is a serious problem , especially among those aged 70 years and over , who might present a target group for active case-finding of the disease .', 'Tuberculosis ( TB ) has become a rare disease in the developed countries but it is still a serious problem in developing countries .', 'Multidrug resistant tuberculosis ( MDR-TB ) is a serious public health problem in Nepal .', 'Tuberculosis ( TB ) is a serious health problem in Tibet where Tibetans are the major ethnic group .', 'Reactivation tuberculosis ( TB ) is a serious problem in immunocompromised individuals , especially those with human immunodeficiency virus ( HIV ) coinfection .', 'Tuberculosis ( TB ) , a dreadful disease known to mankind continues to be a problem in a developing country like India .', 'Tuberculosis is a serious public health problem worldwide , particularly in developing countries .', 'Hence , tuberculosis is once again a serious global problem not only in the developing countries of Africa or South East Asia , but also in highly-developed communities .', 'Multidrug-resistant tuberculosis in children is a severe form of tuberculosis , which remains a major health problem especially in developing countries .', 'Tuberculosis ( TB ) is still a severe public health problem ; the current diagnostic tests have limitations that delay treatment onset .', 'Tuberculosis ( TB ) , with the Mycobacterium tuberculosis ( Mtb ) as the causative agent , remains to be a serious world health problem .', 'Tuberculosis , a global health problem and highly prevalent in India , has always been a serious problem with respect to definitive diagnosis .', 'It is essential to highlight this alarming presentation in a child , as the presence of tuberculosis has re-emerged as a serious public health problem especially in developing countries .', "Tuberculosis remains the world 's leading cause of death from an infectious agent , and is a serious health problem in Papua New Guinea ( PNG ) with an estimated 36,000 new cases each year .", 'Tuberculosis has become a rare disease in the developed countries but it is still a serious problem in the developing countries .', 'Despite advances in the diagnostics and treatment of tuberculosis ( TB ) this diseases still poses a serious medical problem .', 'Tuberculosis is a major threat to global health and its increased incidence in adolescents as well as onset in the elderly presents a serious problem .', 'Tuberculosis ( TB ) remains a serious health problem worldwide , and the only available vaccine , bacillus Calmette-Guérin ( BCG ) , has shown highly variable efficacy in adults against TB .', 'Tuberculosis represents a serious public health problem and a significant diagnostic and therapeutic challenge worldwide .', 'The development of a new vaccine against Mtb is essential to control global spread of tuberculosis , since the current vaccine BCG is not very effective and antibiotic resistance is a serious , burgeoning problem .', 'To this end , reactivation of latent tuberculosis infection represents a serious concern of anti-TNFalpha antibody therapy .', 'The fact that a prior BCG scar is not associated with a positive response to the TT indicates the need to re-open discussion of the guidelines which exist in many poor countries where tuberculosis is still a serious public health problem .', 'The problem with the emergence of HIV-associated tuberculosis ( which usually occurs in young adults ) is that attention has been diverted away from the fact that , in the developed world , the elderly represent the biggest pool of tubercular disease and therefore the greatest pool of infection within the community .', 'Tuberculosis is a serious public health concern especially in Africa and Asia .', 'Tuberculosis caused by Mycobacterium tuberculosis ( MTB ) remains a serious global public health concern .', 'Tuberculosis ( TB ) remains a serious health problem worldwide , and an urgent need exists to improve or replace the available vaccine ,', 'Tuberculosis ( TB ) , caused by Mycobacterium tuberculosis ( Mtb ) , remains a serious global health problem in the 21', 'Mycobacterium tuberculosis ( TB ) infection remains a serious problem in many underdeveloped countries .', 'Tuberculosis is a serious health problem in India , but because of inadequate facilities for diagnosis in many parts of the country clinical data are incomplete .', 'Tuberculosis ( TB ) is a serious public health problem in developing countries such as Pakistan .']


Cluster  2243
['Biofilm formation by Salmonella is a serious concern in the food-processing industry and the persistence of the organism in biofilms becomes a constant source of contamination .', 'Bacterial cells at biofilm stage also are more tolerant to sanitizers compared   with their planktonic counterparts , which makes STEC biofilms a serious food safety concern .', 'Biofilm represents a serious problem in food industry , since it is a constant and important contamination source and also , bacteria present in it have an increased resistance towards physical and chemical agents of common use .', 'Given these anti-biofilm properties and considering that biofilm formation is a serious problem for the food industry and human health , PEOVW has proved to be a high-value natural product .', 'It is widely acknowledged that biofilm has become a serious problem in the food industry , as the biofilm growth mode induces microbial resistance to chemical disinfection .', 'Biofilms in the food-processing industry are a serious concern due to the potential for contamination of food products , which may lead to decreased food quality and safety .', 'In the meat industry , biofilms remain a serious concern because many foodborne pathogens can form biofilms in areas at meat plants that are difficult to sanitize properly , and biofilm cells are more tolerant to sanitization than their planktonic counterparts .']


Cluster  1165
['However , aetiologies differ considerably between intensive care units , and the increase in antibiotic resistance and nosocomial outbreaks worldwide have presented clinicians with a serious dilemma with respect to selecting appropriate empirical therapy .', 'Bacterial resistance against antibiotics is still a serious clinical problem among ICU patients , therefore , surveillance of antimicrobial resistance should be strengthened , and the use of the third-generation cephalosporins should be restricted .', 'Bacterial resistance to antimicrobial agents is a serious problem in the treatment of Pediatric bacterial infection .', '( 3 ) Drug resistance of isolated pathogenic bacteria in department of pediatrics is a serious problem .', 'Pandrug-resistant ( PDR ) bacterial infections in intensive care units are emerging as a severe problem .', "Oflaxacin , although not normally recommended for use in children , could be a potential ' rescue ' drug should multi-drug resistance become a serious problem ; more clinical experience with its use in children is urgently needed .", 'Gram-negative infections are a serious concern among hospitalized patients and require innovative pharmacokinetic dosing strategies to achieve clinical success , especially as the emergence of resistant gram-negative pathogens has outpaced the development of new antibiotics .', 'Parenteral ampicillin is still a mainstay of the treatment of Hemophilus meningitis , but the recent appearance of ampicillin resistant strains may become a serious problem .', 'Ampicillin resistance in Enterococcus faecium is a serious concern worldwide , complicating the treatment of E. faecium infections .', 'NTS represents a major cause of paediatric gastroenteritis in Guangzhou , China , and the high level of resistance to third-generation cephalosporins coupled with increasing resistance to quinolones among isolated NTS from paediatric gastroenteritis is a serious public health concern that requires continued monitoring and rational usage of antibiotics .', 'Multiple-drug-resistant enterococcal infections canbe a serious problem in pediatric patients particularly concomitance with severe underlying diseases and lead to significant morbidity and mortality .', 'The magnitude of the effects on enprofylline plasma levels and renal clearance from high doses of ampicillin do not suggest that interaction with beta-lactam antibiotics will be a serious problem for patients on enprofylline treatment .', 'Increased resistance to third-generation cephalosporin ( 3GC ) is a serious concern for community-onset Escherichia coli infection because this resistance easily delays effective treatment .', 'Multidrug-resistant ( MDR ) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit ( PICU ) .', 'The choice of an antibiotic for the treatment of a serious paediatric infection is generally a difficult problem .']


Cluster  360
['CC16 may serve as a diagnostic and stratification marker for ARDS.', 'The prognostic importance of Cav-1 expression was retrospectively analyzed by immunohistochemistry in 148 patients with gastric cancer who had undergone radical gastrectomy.', 'ADAM9 expression is increased in EAC.', 'The serum CC16 levels in ARDS patients were significantly higher than that in non-ARDS patients (54.', "We assessed the expression of five ADAMs (9, 10, 12, 17, 19) in three esophageal cell lines (Het-1A, OE19, OE33) by RT-PCR and Western blotting, and in human samples of normal esophagus, esophagitis, BE, Barrett's dysplasia, and EAC by RT-PCR, and in selected samples by immunohistochemistry.", 'Cav-1 expression was positive in 23 (15.']


Cluster  859
['HH-related mutations were the most frequent cause of hyperferritinaemia in a Danish blood donor population, and it appears that several different HH-genotypes can contribute to hyperferritinaemia.', 'According to our results, detecting HLA-DRB1*15:03 and HLA-DRB1*11 alleles are useful in the pre-transfusion test and could determine responder patients and improve transfusion safety.', 'The HLAMatchmaker algorithm alone is not a sufficient tool for donor selection.', 'As the number of successful marrow transplants has increased , the lack of HLA-identical sibling donors for 60 to 70 percent of transplant candidates has become a serious problem .', 'Despite the obligate iron loss from blood donation, some donors present with hyperferritinaemia that can result from a wide range of acute and chronic conditions including hereditary haemochromatosis (HH).', 'In 62% of the 270 transfusions, HLA antibodies against the transfused platelets were present, with a median cumulative MFI level of 2026 (range: 299-29\u2009203).', 'A total of 270 HLA-typed platelet transfusion responses of 40 patients were included in the study.', 'Rh deficiency phenotypes are rarely found worldwide and are characterised by the lack of Rh antigen expression on RBCs']


Cluster  778
['A major drawback of filamentous phage is its size .', 'Today , multi-drug resistant bacteria are a serious health problem , and phage therapy enjoys renewed interest .', 'Most phage-resistant Y. pestis mutants become attenuated and thus should not pose a serious problem for bacteriophage therapy of plague .', 'Along with increasing worldwide fruit and vegetable consumption , plant diseases and human foodborne illnesses are becoming a serious economic problem , resulting in a focus on optimization of phage treatment .', 'A drawback of the common phagemid/helper phage systems is the high infective background of phages that do not display the protein of interest , but are propagated due to non-specific binding to selection targets .', 'However , a major drawback of phage display technology is that because the degree of the enrichment can not be controlled during the bio-panning process , it frequently results in a limited number of clones .', 'In earlier studies the inability of phages to kill intracellular bacteria has been thought to be a major drawback of phage therapy .']


Cluster  1212
['Interventions that aim to target discordant couples must embrace the complex and dynamic understandings of HIV diagnosis and treatment in context of fluid relationships, and changing beliefs about HIV risk and treatment.', 'As with other forms of violence including elder abuse , child abuse , and domestic violence , WPV in the ED is a preventable public health problem that needs urgent and comprehensive attention .', 'This feasibility study suggests that PM+ delivered by lay health workers is an acceptable and safe intervention to reach women experiencing common mental disorders and be inclusive for those affected by GBV and can be studied in a RCT in this setting.', "Although such interventions could conceivably be used to promote individual ( and couple ) well-being , their widespread development and/or adoption might lead to the ' medicalization ' of human love and heartache -- for some , a source of a serious concern .", 'The qualitative research found that the intervention was thoroughly enjoyed by patients and clinicians , but a fundamental problem with it was that patients received confused messages about the relation between HIV/AIDS and other STDs .', 'Content analyses of the focus group suggested that GBV is a serious problem among Kenyan college students ; GBV intersects with other problematic health behaviors like problem drinking , and despite some challenges ( e.g. , resources , time ) , VKCP is perceived to be effective at preventing GBV and supporting survivors of GBV .']


Cluster  693
['The main aim of this study was to describe and compare both foot and general health-related QoL in two groups of participants: (i) with MHL and (ii) healthy controls.', 'Foot problems were associated with frailty level and decreased motor performance and PA.', 'Participants (N = 68) were asked about their sociodemographic characteristics, pain level in the last week using the Visual Analog Scale (VAS), and functionality in activities of daily living with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).', "This paper contributes to the identification of risk factors for KOA progression via a robust feature selection ( FS ) methodology that overcomes two crucial challenges : ( i ) the observed high dimensionality and heterogeneity of the available data that are obtained from the Osteoarthritis Initiative ( OAI ) database and ( ii ) a severe class imbalance problem posed by the fact that the KOA progressors class is significantly smaller than the non-progressors ' class .", 'This NEMEX-KOA program was designed for physically active middle-aged patients with mild to moderate KOA; therefore, it involved exercises and difficulty levels that were more challenging than a previously described NEMEX program for patients eligible for total joint replacement.', 'No significant group-by-time interaction was observed for the Disabilities of the Arm, Shoulder and Hand questionnaire, Western Ontario Rotator Cuff index, visual analog scale, and acromiohumeral distance (P≥.', 'Our statistical results revealed no significant difference in outcome between the 2 groups regarding visual analog scale score for leg pain and Oswestry Low Back Pain Disability Index.', 'The results of the current study demonstrate that the Hebrew version of the WOSI is a valid instrument that can be used to assess disability in patients with shoulder instability.', 'The CB&M demonstrated the measurement of three distinct factors, interpreted as lower limb strength, balance and mobility, supporting the use of the CB&M with people with knee OA for evaluation of these important factors in falls risk and functional mobility.', 'Good prediction of QF atrophy in the first postoperative month can be made from studied variables, with isometric endurance and knee extension ROM deficit being the most significant contributors.', 'The Spearman rank correlation coefficient was used to investigate the association between the shoulder pain, range of motion, and disability.']


Cluster  495
['While significant reduction of serum alkaline phosphatase and GGT were seen with vitamin D and calcitriol supplementation from baseline levels, no beneficial effects was seen when comparing vitamin D, calcitriol and placebo groups at the end of trial.', '25-OH vitamin D levels were assessed in two cohorts: Cohort 1 (vertebral fractures; VF) and Cohort 2 (other spinal issues; excluding VF).', 'This study aimed to determine the effects of sunlight exposure compared with oral supplementation with vitamin D2 (weekly 20,000 IU) in combination with sunlight exposure on 25(OH)D levels.', 'This dilemma represents a serious problem in many populations , for an association of vitamin D-deficiency and multiple independent diseases including various types of cancer has been convincingly demonstrated .', 'This dilemma represents a serious problem in many populations , for an association of vitamin D-deficiency and multiple independent diseases has been convincingly demonstrated .', 'Vitamin D insufficiency was independently associated with coronary tortuosity.', 'This dilemma represents a serious problem , for an association of vitamin D-deficiency and multiple independent diseases including various types of cancer , bone diseases , autoimmune diseases , infectious diseases , cardiovascular diseases and hypertension has now been reported in a large number of laboratory and epidemiologic investigations .', 'A combination of weekly vitamin D2 supplementation at a dose of 20,000 IU with sunlight exposure is more effective than sunlight exposure alone in postmenopausal Thai women.', 'Mean baseline serum 25-hydroxyvitamin D (25(OH)D) level was 60\u2009nmol/L.', "The primary objective of the 'Palliative-D' study is to test the hypothesis that vitamin D supplementation for 12 weeks reduces opioid consumption.", 'In a double blind, randomized, placebo controlled trial patients with NAFLD were randomized to receive one weekly pearl of placebo, 50,000\u202fU vitamin D3 (cholecalciferol) pearl per week and 0.', 'Low vitamin-D levels were more frequent in RA patients (p < 0.', 'On the other hand , vitamin D deficiency ( VDD ) is also a serious public health problem with significant impacts and multiple health effects .', 'Vitamin D deficiency is a serious public health problem worldwide that affects not only skeletal health , but also a wide range of acute and chronic diseases .', 'Majority (99%) of the cohort was vitamin D sufficient (>50 nmol/l or 20\u2009ng/ml).', 'Vitamin D deficiency is a preventable health problem .', 'The observational studies conducted by our group revealed that vitamin D insufficiency does not seem to be a serious problem among active elderly people , but that elderly people with a low level of activities of daily living ( ADL ) are at a very high risk of vitamin D insufficiency .', 'In RA patients, serum vitamin-D level was significantly and inversely associated with both PROs and disease activity.', 'Recent national data indicated an inverse association between vitamin D status and coronary heart disease ( CHD ) , which increases concerns about vitamin D deficiency as a serious public health problem .', 'Vitamin D deficiency has been highlighted as a serious public health problem in the United Kingdom .', 'The prevention of fragility fractures in patients with sarcoidosis is a serious concern and the potential risk of hypercalcemia limits vitamin D and calcium supplementation .', 'We aimed to investigate the association between serum 25-hydroxyvitamin D (25-OH VD) with coronary tortuosity (CT) in patients with normal or near-normal (< 40% stenosis) coronary arteries.', "With vitamin D deficiency as a serious public health problem , vitamin D status at birth was measured in neonates at latitude 32 degrees 72 ' ( southeastern United States ) ."]


Cluster  267
['The aim of this study was to investigate associations between different methods of systolic pressure assessment in a large cohort and its comparison with recently published evidence.', 'This study aimed to examine the effects of measurement room environment and nursing experience on the accuracy of manual auscultatory blood pressure (BP) measurement.', 'During a public health campaign, cardiovascular hemodynamic data were assessed using a validated oscillometric device in a pharmacy setting.', 'The increased risk in subjects with diastolic pressure below 60 cannot fully be explained by the intensive treatment itself, but may be due to other measured factors.', 'In our point of view , the problem with using blood pressure as a measurement is that it can be affected by many other factors unrelated to cardiac denervation .', 'Our results indicate that frequent nursing trainings are important for nurses to achieve accurate manual auscultatory BP measurement.', 'To explain the excess cardiovascular mortality observed in the SERVE-HF study, it was hypothesized that the high-pressure ASV default settings used lead to inappropriate ventilation, cascading negative consequences (i.e. not only pro-arrythmogenic effects through metabolic/electrolyte abnormalities, but also lower cardiac output).', 'Lack of convincing data on prognosis of patients whose antihypertensive treatment has been guided by 24-hour BP monitoring also presents a serious problem .', '4 . Errors in indirect measurement of blood pressure are a serious problem , particularly in the elderly .', 'However , the problem with clinical use of baPWV is that the index itself is closely dependent on blood pressure .', 'Manufacturer-supplied blood pressure (BP) cuffs are part of the automatic oscillometric BP devices algorithm.']


Cluster  240
['A randomized, double blind, parallel-group trial was carried out on 30 patients suffering from chronic generalized periodontitis with probing pocket depth≥5mm on at least 4 sites who were then randomly allocated to two groups.', 'We conducted a prospective longitudinal observational study to describe dental plaque, gingivitis, and mucositis in the peritransplant period.', 'The results show that , as in other countries , dental disease is a serious problem for sheep in Slovenia .', 'Time under and form of immunosuppression might have an impact on the clinical periodontal and microbiological parameters of patients after SOT.', 'Our results suggest that there may indeed be an association between obesity and periodontitis in male patients with DS.', 'Periodontal disease is a serious dental problem because it does not heal naturally and leads to tooth loss .', 'Twenty-six posterior sextants requiring osseous resective surgery were selected in 13 patients with chronic periodontitis: 13 sextants were randomly assigned to ORS and 13 to FibReORS in a split-mouth design.', 'Significant positive correlations were observed among the anthropometric parameters BMI, WHR, WHI and among the periodontal parameters PI, PD, CAL and GI.', 'In this period of time, the most prevalent pathology acute apical periodontitis, odontogenic abscess reported the lowest frequency and prosthetic-orthodontic treatments were the third in number of cases.', 'It was concluded that , while changes in feeding methods in recent decades have arguably improved pet health by reducing or preventing diseases associated with nutritional deficiencies and excesses , periodontal disease remains a serious , diet-related problem .', 'Periodontal disease is considered a public health problem because of its high prevalence , while premature birth is a serious perinatal problem , persisting as one of the major causes of perinatal mortality and morbidity .', 'TG2A did not play an independent role on SED in the primary dentition during pregnancy and childhood, and the relationship may be explained by ethnic and socio-economic background.', 'Based on the International Classification of Periodontal Diseases , approximately 50 % of adults in France may suffer from a severe attachment loss problem .', 'Patients not completing a course of periodontal therapy are at risk of further tooth loss and deterioration in periodontal conditions over time.']


Cluster  1586
['Single-centre, randomised clinical trial of patients affected by periampullary cancer who underwent pancreaticoduodenectomies which included two different types of margination: arm A (multicolour inking) and arm B (monocolour inking).', 'Between 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database.', '3 . Carcinoma of the proximal pancreas is a serious medicosurgical problem , and radical pancreatoduodenectomy is the most effective form of therapy .', 'Some 120 patients undergoing pancreatoduodenectomy were included following consent.', 'We retrospectively analysed data from all patients who underwent pancreatic resection for periampullary cancer with curative intent (R0 or R1).', 'However , a decrease in quality of life becomes a serious problem after total pancreatectomy because of the abolition of endocrine and exocrine pancreatic function .', 'Marginal ulceration is a serious problem after both standard pancreaticoduodenectomy ( PD ) and pylorus-preserving pancreaticoduodenectomy ( PPPD ) .', 'Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management', 'Hemorrhage is a rare but dreaded complication after pancreatic surgery.', 'To determine and compare the cost-effectiveness of an early precut approach versus pancreatic duct stent placement for the prevention of post-ERCP pancreatitis.', 'Acute pancreatitis is one of the less frequently diagnosed lethal abdominal complications of cardiac surgery.', 'Pancreatic fistula ( PF ) after pancreaticoduodenectomy ( PD ) is still a severe complication and a challenging problem .', 'Enucleation is a safe and feasible procedure for benign or low-grade pancreatic neoplasms.', 'Sixty-eight patients who underwent subtotal stomach-preserving pancreatoduodenectomy were included.', 'The 611 patients who had an extended pancreatectomy had significantly greater surgical morbidity than the 1217 patients who underwent a standard resection (42·7 versus 34·2 per cent respectively), and higher 30-day mortality (4·3 versus 1·8 per cent) and in-hospital mortality (7·5 versus 3·6 per cent) rates.', 'Patients scheduled for elective pancreatic surgery at the University of Heidelberg were screened for eligibility.']


Cluster  1879
['Prolonged contamination with the constant infiltration of crude oil into the soil is a severe problem in remediating contaminated soils .', 'Blackwater events are frequently reported over the world and become a serious environmental problem .', 'Ground and surface water contamination resulting from the leakage of crude oil and refined petroleum products is a serious and growing environmental problem throughout the world .', 'Unplanned oil spills during offshore oil production are a serious problem for the industry and the marine environment .', 'Contamination of groundwater by petroleum-hydrocarbons is a serious environmental problem .', 'Contamination of groundwater by gasoline and other petroleum-derived hydrocarbons released from underground storage tanks ( USTs ) is a serious and widespread environmental problem .', 'Soil contamination with petroleum , especially in the area of oil wells , is a serious environmental problem .', 'Generation of process waters contaminated by naphthenic acids is a serious environmental concern associated with processing of the oil sands .']


Cluster  1612
['Within the last decade , human infections caused by enterobacteria which produce the Klebsiella pneumoniae carbapenemase ( KPC ) became a serious therapeutic and epidemiological problem worldwide .', 'Emergence and spread of specific carbapenem-resistant Acinetobacter baumannii ( CRAB ) clones cause a serious therapeutic problem .', 'The dissemination of carbapenemase-producing Enterobacteriaceae is currently considered a serious clinical problem due to the failure in the treatment of infections produced by them .', 'Infections caused by carbapenem-resistant enterobacteria ( CRE ) are classified as a serious problem .', 'Carbapenem resistance among Pseudomonas aeruginosa has become a serious life-threatening problem due to the limited therapeutic options .', 'Carbapenem resistance among MDR ( CR-MDR ) P. aeruginosa has become a serious life-threatening problem due to the limited therapeutic options .', 'The emergence and spread of carbapenemase-producing Gram-negative bacteria represents a serious public health concern .', 'Carbapenem resistance among Acinetobacter species has become a life-threatening problem .', 'The increasing spread of carbapenem resistance is a serious global public health concern that negatively affects human and animal health .', 'The emergence and rapid spread of carbapenemase-producing Enterobacterales represents a serious public health concern .', 'The spread of Enterobacteriaceae producing both carbapenemases and Mcr , encoded by plasmid-mediated colistin resistance genes , has become a serious public health problem worldwide .', 'Carbapenem resistant Enterobacteriaceae ( CRE ) has become a serious public health problem .', 'Carbapenem-resistant Acinetobacter ( CRA ) is becoming a serious concern with increasing patient morbidity , mortality , and lengths of hospital stay .', 'Carbapenemase-producing organisms ( CPOs ) are a serious emerging problem for health care facilities worldwide .', 'The emergence and spread of Carbapenem-resistant Escherichia coli ( CREC ) is becoming a serious problem in Chinese hospitals , however , the data on this is scarce .', 'Multidrug resistant bacteria are a serious worldwide problem , especially carbapenem-resistant', 'The spread of plasmids carrying carbapenemase genes resulting in fulminant antimicrobial resistance is a severe concern .', 'The emergence of multiple-carbapenemase-producing Acinetobacter strains has been a serious concern during the past decade .', 'The development of colistin resistance in carbapenem-resistant strains poses a serious public health problem .', 'Carbapenem-resistant organism ( CRO ) colonization is a serious problem that increases the risk of infection and contributes to dissemination of antimicrobial resistance in healthcare-associated environments .']


Cluster  2134
['Despite decades of study , subarachnoid hemorrhage ( SAH ) continues to be a serious and significant health problem in the United States and worldwide .', 'Subarachnoid hemorrhage ( SAH ) is a serious medical problem with few effective pharmacotherapies available , and neuroinflammation has been identified as an important pathological process in early brain injury ( EBI ) after SAH .', 'The development of delayed cerebral ischaemia and hence neurological deficit remains a serious problem following subarachnoid haemorrhage .', 'Current guidelines recommend noncontrast computed tomography (NCCT) followed by lumbar puncture for the diagnosis of subarachnoid hemorrhage (SAH).', 'While the risk of aneurysmal rebleeding induced by catheter cerebral angiography is a serious concern and can delay angiography for a few hours after a subarachnoid hemorrhage ( SAH ) , current angiographic technology and techniques have been much improved .', 'Cerebral vasospasm remains a serious problem affecting morbidity and mortality in patients with subarachnoid hemorrhage ( SAH ) during neurosurgery .', 'Aneurysmal subarachnoid hemorrhage is a serious medical and social problem .']


Cluster  187
['The selected formula displayed spherical morphology, particle size of 15.', 'A potential drawback of a nanoadsorbent is the difficulty of particle settling and separation because of its high dispersivity in solution .', 'In these terms , the problem is that many particles have a sentential usage', 'A drawback of particles containing a ZnO hemisphere is their low stability in biological environment due to the amphoteric properties of Zn', 'Following the evaluation methodology of Snow et al. many particles have a sentential usage', 'The formation of a ring-like deposit at the periphery of a drying colloidal droplet is a vexing problem in many applications .', 'A drawback of studies on bulk nanobubbles is the absence of direct proof that the nano-objects reported are really nanobubbles .']


Cluster  386
['In conclusion , T. \xa0 gondii infection is a severe problem in cancer patients and it is imperative that improved integrated measures should be conducted to prevent and control T. \xa0 gondii infection in cancer patients .', 'Robust detection of bacteria can significantly reduce risks of nosocomial infections , which are a serious problem even in developed countries ( 4.1 million cases each year in Europe ) .', 'Streptococcal toxic shock syndrome is a serious health problem in developed and developing countries .', 'Increasing rates of gonococcal ( GC ) infection and antimicrobial resistant ( AMR ) GC , are a serious public health concern for Canada and around the world .', 'Some have suggested that P. putida functions as an exchange platform for antibiotic resistance genes ( ARG ) , and thus represents a serious concern in the spread of ARGs to more pathogenic organisms within a hospital .', 'Streptococcus mutans is a major etiologic agent of dental caries , a prevalent worldwide infectious disease and a serious public health concern .', 'Gonococcal infections are now an uncommon problem in newborns in industrialized countries but remain a serious problem in developing countries due to ongoing high infection rates in pregnant women .', 'Multiresistant nosocomial pathogens , especially Gram-negative bacilli ( GNB ) , are a serious problem for public health systems worldwide .', 'Nosocomial infections caused by multiresistant Gram-positive cocci are a serious problem for public health systems worldwide .', 'Bacterial infections caused by Group A Streptococcus ( GAS ) are a serious health care concern that currently can not be prevented by vaccination .']


Cluster  1866
['Mean age was 82\u2009±\u20097\xa0years.', 'The mean age and median follow-up were 63.', 'Mean age of the participants was 60.', 'The mean age was 61.', 'The median age was 55.', 'The mean age of Group 1 was 58.', 'The mean ± SD age of patients was 55.', 'The mean age at presentation was 60±5.', 'The mean aged of the population was 69.', 'The median age of participants was 53.']


Cluster  1289
['cohort study of 600 patients admitted for acute HF, defined according to the European Society of Cardiology criteria.', 'In this predominantly African-American cohort of hospitalized patients with advanced HF, PCC did not lead to a greater likelihood of comfort care election compared with usual care.', 'Echocardiograms on all patients hospitalized for HF exacerbation attributed to dietary or medication noncompliance were retrospectively assessed for the presence of significant changes from prior echocardiogram.', 'Age is an independent predictor of mortality but not readmissions in elderly patients with first HF hospitalization.', 'We analyzed 145 patients admitted consecutively to a cardiology department for acute HF.', "A time course assessment related to in-hospital mortality during the hospitalization of AHF patients can clearly categorize a patient's on-going status, and may assist patients and clinicians in deciding treatment options.", 'Twenty-six patients with chronic HF were randomly assigned to either 8 weeks of IMT or a control group.', 'Though this study is observational and does not allow for causal inference, it may nonetheless be speculated that a greater accumulation of Cl in the blood vessels acts to increase or maintain intravascular volume, which induces different clinical features of HF.', 'Monitoring changes in SBP assisted risk stratification of AHF patients, particularly patients with intermediate ER-SBP measurements.', 'Patients with prior HF admitted to hospital with PTE should be considered a high-risk population, since they present high in-hospital mortality.', 'The TACTICS-HF study randomized patients (n\xa0= 257) within 24 h of AHF presentation in a prospective, double\xa0blind, placebo-controlled trial.', 'To quantify the incremental risk of ischemic stroke among newly diagnosed patients with HF and without AF.', 'Repeat echocardiograms in patients admitted with HF exacerbation due to noncompliance revealed significant changes in the majority of patients studied.', 'These results indicated that AF is associated with worse prognosis in patients at high risk of HF, and our new risk score may be useful to identify patients at high risk for AF onset.', 'Data from 47 patients with acute on chronic HF worsening were analyzed.', 'Patients with longer HF duration had significantly worse outcome compared to those with short HF duration, even when adjusted for patient age and comorbidities.']


Cluster  1388
['Data from 331 participants were analysed.', 'Nine participants were enrolled.', 'A total of 137 participants completed the study.', 'The 38 subjects were recruited from a rural community of Northern China.', 'A total of 368 people participated in the study (participation rate: 33%).', 'The number of participants required for this study is 68, and is currently recruiting participants.', 'Data from 380 participants were studied.', 'In all, 137 students were randomized.', 'To date, 35 participants have consented to participate in the study.', 'Thirty subjects were included.', 'Participants (N.', 'A total of 136 subjects were included in this study.', 'Forty-one subjects (mean 9.', 'A total of 33 subjects completed the study.', 'In total, 34 subjects aged 11.', 'Thirty-nine subjects participated to a placebo-controlled study.', 'Thirty-nine participants were recruited.']


Cluster  2145
['Aesthetic changes in the aging upper lip constitute a troublesome problem for modern women .', 'To assess perceived naturalness of facial expression after treatment with 2 HA fillers manufactured with XpresHAn Technology (also known as Optimal Balance Technology).', 'To evaluate the safety and effectiveness of VYC-15L for lip and perioral enhancement versus a nonanimal stabilized HA with lidocaine (Restylane-L; NASHA).', 'CaHA is a very effective agent for restoring jawline contour in routine practice and is associated with high levels of physician and patient satisfaction.', 'The aim of this study was to determine the efficacy and safety of small-particle hyaluronic acid with lidocaine (SP-HAL) microaliquots for the correction of fine lines of the cheeks.', 'Recent studies have found that most injectable fillers are met with success and patient satisfaction , but vascular complications are still a serious problem of which physicians should be wary .', 'To compare the long-term safety and effect of 2 HA fillers produced by 2 different technologies for lip enhancement.', 'This prospective multicenter study randomized 225 adults with minimal, mild, or moderate lip fullness on the validated 5-point Allergan Lip Fullness Scale (LFS) to treatment with VYC-15L or NASHA; optional touch-up was administered 30 days later.']


Cluster  818
['Adhesiolysis during abdominal surgery can cause iatrogenic organ injury, increased operative time and a more complicated convalescence.', 'To determine the prevalence of abdominal re-operations in patients undergoing elective and emergency surgery in the General Hospital of Matamoros.', 'Ratios of MODS, mortality, hospitalization time, hospitalization cost, the abdominal distention relief time, abdominal pain relief time, concentration of endotoxin, TNF-α, IL-6, IL-8, and APACHE II scores were significantly decreased in the CVVDH, LPLD, and CVVDH+LPLD groups, while ratios of recovery were significantly increased in the CVVDH, LPLD, and CVVDH+LPLD groups, especially in the CVVDH+LPLD group.', 'Observational cohort of 874 patients undergoing major abdominal elective surgery between January 2009 and March 2014.', 'The management of a septic peritonitis open abdomen is a serious problem for clinicians .', 'An observational, prospective, single-center study was conducted in patients undergoing abdominal surgery for cancer.', 'As a complication after surgery for abdominal aortic aneurysms , colonic ischemia remains a serious problem , especially in cases of ruptured AAA .', 'Intra-abdominal infections are a serious problem for surgeons .', 'Open abdomen with vacuum assisted closure (VAC) is an alternate method to primary abdominal closure (PAC) in select situations for the management of severe surgical abdominal sepsis or septic shock.', 'Intra-abdominal abscess , resulting either from primary intraperitoneal disease or as a complication of surgery , remains a serious problem with high patient mortality if not treated early and adequately .', 'We conducted a prospective randomized trial in 41 adult female patients who underwent elective abdominal surgery.', 'Abdominal abscesses arising postoperatively constitute a serious problem , particularly in the field of oncological surgery .', 'The combination of IAP with ARPI in a mathematical model can add accuracy to the prediction of need for re-operation related to intra-abdominal infectious complications in patients following abdominal surgery.', "Postoperative intra-abdominal septic complications are a serious concern with regard to postoperative morbidity and mortality in Crohn 's disease .", 'Abdominal infection complicating abdominal operation is a serious clinical problem that is subject to diagnostic delay , which is a risk factor for adverse outcomes .']


Cluster  1204
['Forty-eight female patients with different grades of cellulite at thighs area were enrolled in this study.', 'Carboxytherapy and mesolipolysis are safe and effective in cellulite treatment.', 'Cellulite is an irregular alteration of the skin surface giving it cottage cheese appearance.', 'Intradermal mesotherapy reduced severity of cellulite.', 'Transcutaneous electric nerve stimulation (TENS) was effective in reducing pain intensity during carboxytherapy in patients with cellulite in the gluteal region.', 'AWT is a safe treatment to improve cellulite appearance and reduce body circumferences.', 'To verify the efficacy and safety of carboxytherapy versus mesolipolysis using phosphatidylcholine (PPC) in treatment of cellulite in thighs area.', 'Intradermal mesotherapy offers effective cellulite reduction.']


Cluster  782
['Median (interquartile range) total morphine requirement was significantly less in patients who underwent LAP blockade 0 (0, 4) than in patients who underwent TAP blockade 21 (10, 27; P < 0.', 'The results of this study suggest that lidocaine patch application to the trocar site after laparoscopic appendectomy may have a positive effect on the management of postoperative pain and can eliminate the need to inject additional analgesics for further postoperative pain control.', 'Postoperative morphine consumption was significantly less immediately postoperatively (p\xa0<\xa00.', 'Our study suggests that TAP block and intravenous lignocaine do not improve the post-operative analgesia provided by systematic administration of paracetamol after open prostatectomy.', 'Gabapentin significantly decreased the postoperative acute pain scores at rest (P=0.', 'VRS and postoperative analgesic requirements were not significantly different between the treatment groups.', 'Analgesia in Ambulatory Surgery (AS) needs to evolve in parallel with surgical complexity.', 'Pregabalin has more effect, safely and usefully than acetaminophen on the management of postoperative pain in the patients with nasal polyposis undergoing functional endoscopic sinus surgery.', 'Automated intermittent boluses did not reduce pain or rescue opioid consumption compared with continuous infusion of ropivacaine.', 'Preoperative gabapentin significantly alleviated acute postoperative pain and decreased the incidence of vomiting in patients undergoing suboccipital or subtemporal craniotomy.', 'Total morphine consumption was reduced and first request of analgesia was delayed in group I compared with that in groups II and III, and in group II compared with that in group III (P=0.', 'Intermittent boluses for neural blockade provide better post-operative analgesia when compared to continuous infusion.', 'Intraoperative ESPB as a part of multimodal analgesia was effective.', 'In the context of the much-heralded advantages of laparoscopic surgery , it can be easy to overlook postlaparoscopy pain as a serious problem , yet as many as 80 % of patients will require opioid analgesia .', 'Intraoperative esmolol infusion is a valid method to reduce postoperative pain, it provide lesser need to analgesics and hemodynamic stability in first 3\xa0hours of post rhinoplasty surgery.']


Cluster  374
['A third of newborns lacked the bracelet as originally placed at the time of discharge.', 'CC+SI is feasible in the delivery room.', 'A supportive-educative nursing intervention programme could effectively improve knowledge of CHX gel for umbilical cord management amongst mothers.', 'The objective of this study was to assess the effectiveness of a supportive-educative nursing intervention programme on knowledge of CHX gel amongst mothers in Cross River State, Nigeria.', 'Cardiotocograph (CTG) interpretation is a core skill for health care professionals working on the labour ward; however, training appears to be deficient in respect of the development of decision-making skills relating to CTG findings', 'To evaluate the permanence of the identification bracelets during the hospitalization.', 'One limitation with the study was that information on prolonged labor was based on discharge diagnoses from the delivery hospital according to the International Classification of Diseases ( ICD ) .']


Cluster  1184
['A major problem with the use of ambulatory electrocardiographic ( Holter ) monitoring in the diagnosis of arrhythmias is that symptomatic correlation with arrhythmias is rarely found ( only 4 % of patients ) .', 'This study suggests that Holter ECGs recorded in a controlled environment are not significantly different but more variable than those from the standard method.', 'Clinical description and the ECG are fundamental for its analysis , but a serious diagnostic problem arises when these do not provide typical data .', 'Patients with symptoms of coronary artery disease (CAD) often display normal tracings or only nonspecific changes on electrocardiography (ECG).', 'Consecutive 24-hour Holter monitoring performed between 2005 and 2010 in a single center was evaluated.', 'The CA/HF distribution of patients was: HF - 58%, bradyarrhythmia - 15%, atrial fibrillation - 15%, other supraventricular tachyarrhythmia - 10% and ventricular tachycardia/fibrillation - 4.', 'The problem with these investigations is that they lack sensitivity as they are sometimes normal in patients with documented VT or lack specificity , ventricular arrhythmias being common and often without clinical significance .', 'Those patients with normal or nonspecific ECGs and CAD (15.', 'ECG from 1000 successive healthy children from birth to 17years old were prospectively recorded and analyzed.', 'ECG data of 152 180 individuals age 18 to 93 years were available.', 'In resting ECGs, at least 1 abnormality was found in 92.', 'Even if the refined criteria rather than the criteria used for normal sedentary population were applied, the vast majority of amateur runners showed at least 1 abnormality in resting ECGs, which were mainly training-related variants.']


Cluster  39
['LVEDV decreased longitudinally during the acute phase of KD with preservation of LVESV, reducing both LVSV and LVEF.', 'NT-proBNP-guided therapy resulted mainly in an increase of diuretics in acute setting and compared with clinical evaluation alone did not improve prognosis.', 'Median NT-proBNP concentrations decreased significantly from admission (1,713 pmol/L [range, 160-3,784 pmol/L]) to discharge (902 pmol/L [range, 147-3,223 pmol/L]); P = .', 'Increasing PSV levels during NIV caused a progressive mismatch between neural effort and pneumatic timing.', 'Prolongation in the QTc interval was "statistically" associated with acute SAH only.', 'Hemodynamics were recorded on 30 patients 20 [16,25] minutes after ED arrival: 50% had a normal SVR, 30% had a high SVR, and 20% had a low SVR.', 'Fluid balance was more relevant to short-term prognosis of CSA-AKI-RRT patients than ultrafiltration volume or ultrafiltration rate.', 'From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened.', 'In patients with severe chronic AR, preoperative LV dysfunction is remarkably improved at 1 year after AVR.', 'A heterogeneous range of hemodynamic states exist post-ROSC rather than consistent vasoconstriction.', 'Multiple SBT attempts, weak cough and low albumin were associated with increased reintubation in medical patients.', 'In all KD patients, LVEDV decreased in the acute phase with preservation of LVESV.', 'Absence of PA was significantly and independently associated with increased NLR and impaired LVEF after reperfusion, and increased NLR was found as a significant predictor for both lack of PA and impaired LVEF in STEMI patients.', 'Of 83 patients, 20 (24%, 95% [confidence interval] CI: 16-34%) had isolated RV dysfunction and/or PH.', 'Plasma volume factor and PCV were independently associated with NT-proBNP (Radj2\xa0=\xa00.', 'Before volume expansion, ΔVpeak, CVCDI and SPV were higher in responders than in non-responders (P=0.', 'A prospective, observational registry was developed to monitor clinical and haemodynamic outcomes in patients with RVOT dysfunction treated with the Melody TPV (Medtronic Inc, Minneapolis, United States).']


Cluster  742
['Craving remains a clinically relevant phenomenon , with most smokers describing craving as a troublesome problem when quitting .', 'The aim of the trial was assessing differences of linear parameters of heart rate variability in subjects with habit of consuming of cigarettes tobacco in regard to subjects who are not consumers of tobacco.', 'The rapid desensitization of alpha7 nicotinic acetylcholine receptors ( nAChR ) has presented a serious problem for the characterization of this receptor subtype , potentially confounding the interpretation of concentration-response relationships .', 'Nicotine addiction is a serious health problem resulting in millions of preventable deaths worldwide .', 'Nicotine Bound to Its Receptors : New Structures for a Vexing Pathopharmacological Problem .', 'The use of nicotine through smoking remains a serious health problem .', 'Addressing nicotine dependence is key to effective smoking cessation', 'A substantial proportion of smokers attending a clinic for help with quitting report that their dominant urges to smoke occur without any anticipation of pleasure or relief and the strength of the automatic urges predicts failure to sustain abstinence following a quit attempt.', 'Nicotine addiction ( NA ) is a serious public health problem and helping patients to stop consumption is a major concern for general practitioners ( GP ) .', 'Smoking is a serious public health problem , and accurate real-time assessment of risk factors associated with smoking is critical to understanding smoking relapse .', 'A general problem with this type of investigation is that continuous nicotine application does not mimic the spike-wise application with cigarette smoking , and may lead to nicotine tolerance .', 'Baseline measures of mean NN intervals and standard deviation of normal to normal interval (SDNN) were slightly lower in subjects consumers of nicotine by cigarette tobacco smoking in regard to nonsmokers but without significant difference (640+-15ms vs 675+-8ms, p<0.', 'Nicotine addiction is a severe public health problem .', 'A limitation of the cost-effectiveness analysis , shared with several previous cost-effectiveness analyses of smoking cessation interventions , is that intervention benefit is restricted to the first quit attempt .']


Cluster  1083
['Occupational risks are becoming a serious problem in developing countries , largely as a consequence of the transfer of hazardous industries from industrialized countries where certain industries are judged to be unacceptable .', 'Previous reports have indicated that injuries involving augers ( screw conveyors ) are a serious problem in agriculture , but to date on-site engineering inspections linking injuries to mechanical and procedural aspects have not been available .', 'We performed a retrospective, observational study of characteristics associated with injuries incurred while using a table saw.', 'Occupational health has become a serious problem in the developing world as new industries and accelerating ecnomic development occur without adequate resources for worker protection .', 'With increasing electrification and mechanization in rural areas , industrial drive-belt or patta injuries have posed a serious problem .', 'Accident proneness : a serious industrial problem .', 'The annual increase in the number of occupational accidents and diseases in the Palestinian manufacturing industries confirms a serious problem that threatens the Occupational Safety and Health ( OSH ) in such industries , with negative consequences in the society and economy .', 'Occupational accidents and injuries present a serious social , medical and economical problem in Serbian industries in transition .']


Cluster  1659
['Secondary glaucoma sometimes poses a serious problem that must be treated by radical measures .', 'shows that failure of filtration in these types of glaucomas is still a serious clinical problem .', 'Primary open angle glaucoma (POAG) and normotensive glaucoma (NTG) patients were randomized enrolled.', '1-week treatment with P4 appeared to be safe 1) in OAG patients treated with topical β-blockers and 2) in NAG patients treated with topical pilocarpine ± β-blockers, irrespective of whether the eyes had previously been treated with glaucoma surgery or laser therapy.', 'Two studies were performed: one in 24 patients with open-angle glaucoma (OAG) treated with topical β-blockers, one in 24 patients with narrow-angle glaucoma (NAG) treated with pilocarpine ± topical β-blockers.', 'Examining the somatic state of glaucomatous patients that enroll for treatment , we are increasingly confronted with a serious problem of inconsistency in prescribing beta-blockers ( β-blockers ) by ophthalmologists , cardiologists and therapists .', 'Choice of optimal hypotensive therapy with the minimal side effects remains a serious problem in therapy of glaucoma .']


Cluster  137
['We studied 28\xa0KD patients without coronary aneurysms (average age, 3.', 'The B-CTO score has been designed and validated in Korean patients with native coronary CTO and is an improved tool for predicting successful recanalization.', 'Fifty patients with acute coronary syndrome and ≥1 <sup>18</sup> FDG uptake in the carotid artery (target-to-background ratio [TBR] ≥1.', 'Forty-six consecutive patients who underwent clinically indicated FFRs at the time of coronary angiography were enrolled between 4/2012 and 5/2014.', 'In patients with STEMI, I-MIBG SPECT, assessing cardiac sympathetic denervation may precisely evaluate the AAR, providing an alternative to CMR for AAR assessment.', 'Retrospective review was undertaken of reports and original coronary angiograms in all patients under 50years old undergoing coronary angiography between 2011 and 2015.', 'Prospectively enrolled CTO patients (n = 438) undergoing coronary intervention (1999-2015) were assessed.', 'In Japan , an ever-present problem in the preoperative evaluation of patients with ischemic heart disease is that although such evaluations are based on Western data , these data serve as the basis for determining perioperative risk in Japanese patients .', 'A high revascularization rate was the drawback of off-pump CABG for CHD patients in long-term follow-up .', 'Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study.', 'QFR had good correlation and agreement with FFR and high diagnostic performance in the evaluation of intermediate coronary stenosis, suggesting that QFR may be an alternative tool for estimating myocardial ischemia.', 'The study assessed all coronary angioplasties performed in a\xa0major metropolitan general hospital.', 'A total of 183 intermediate native coronary artery lesions from 112 patients were prospectively enrolled into this study.', 'These data suggest that fewer than half of patients with OHCA undergoing emergency coronary angiography present with AMI.', 'We performed a single-center retrospective analysis of 379 consecutive patients who underwent a variety of diagnostic and interventional left- and right-heart procedures through upper extremity and femoral access sites.', 'In the CULPRIT-SHOCK trial, a core laboratory reviewed all coronary angiograms to identify CCLL.', 'In the WAVE study, a prospective, observational, single-center registry (NCT02869906), paired iFR and FFR measurements were performed at the level of non-IRA lesions in patients with ST-segment elevation myocardial infarction both during primary PCI and during staged procedures (5-8 days after).']


Cluster  53
['Twenty-three patients (10 in MTH preservation group) were included and analysed.', "Kambin's triangle was investigated with surgical views and cadaver studies.", "Retrocolic RY with appropriate closure of defects can reduce IH incidence at Petersen's defect and at jejunojejunostomy mesenteric defect.", 'Postoperative immuno-suppression caused by TAH has become a serious clinical problem , due to the high incidence of infectious complications after this operation .', 'The decision to clip and cut the cystic duct was jointly made by members of the surgical team, rather than a solitary surgeon in the majority of cases, involving verbal explication of clinical reasoning and verbal agreement.', 'One major surgical complication (C-D IIIb) occurred.', 'The later the PDA surgery was performed, the later the infection occurred.', 'Only 6 of the 34 patients had type 3 triangles, which is the wide classical triangle described by Kambin; however, 17 patients had type 2, with a narrow space in the triangle, and 11 patients had type 1, with no space inside the triangle.', '[ Agenesis of the ductus venosus -- an irrelevant anomaly or a severe clinical problem ? ] .', 'Complications were registered and graded according to the Clavien-Dindo (C-D) classification.']


Cluster  604
["We have developed a system to analyze the position of labor by quantifying the posture of the woman's body parts (including thighs, trunk, and pelvis), using an optoelectronic motion capture device (Vicon™, Oxford Metrics) widely used in human movement analysis and a system for measuring the lumbar curve (Epionics spine system).", 'This methodology could become a reference for assessing delivery postures, one that makes it possible to describe the relation between the postures used in the delivery room and their impact on the pelvis and the spine in an integrated and comprehensive model.', 'Proposed model revealed excellent concurrent validation measures between an applied input angle to the recorded output angle from the kinematic model.', 'Predicting BW through WUB in supine position is effective and reliable because the latter can be easily measured and features a strong linear relationship with BW.', 'Success rates for accurate UAC placement are highest when formulae that involve body measurements are used.', 'To develop and validate a new multi-segment kinematic model to assess regional three-dimensional movement of the lumbar, lower thoracic and upper thoracic spine during gait.', 'Error differences revealed that, while both models were similar in the mediolateral direction, the head-trunk-pelvis model had less error in the anteroposterior direction and the pelvis model had less error in the vertical direction.', 'Although slight proportional errors were possible, values from standard 5-minute and shorter recordings in the supine position were strongly correlated.', 'Results showed that WA and UL isometric force were moderately to highly correlated with clinical measures.']


Cluster  432
['A serious problem during purification of the E. coli initiation factor IF2 is a significant loss of native IF2 due to partial degradation .', 'An inherent problem with bacterial cell factories used to produce recombinant proteins or metabolites is that resources are channeled into unwanted biomass as well as product .', 'A drawback of biotechnological processes , where microorganisms convert biomass constituents , such as starch , cellulose , hemicelluloses , lipids , and proteins , into wanted products , is the economic feasibility .', "Fermentations carried out at 450-L and 20-L scale to produce Fab ' antibody fragments indicated a serious problem to control levels of dissolved oxygen in the broth due to the large oxygen demand at high cell densities .", 'A drawback of this expression method is the serendipitous ability of P(LAC4 ) to promote gene expression in Escherichia coli .', 'In order to overcome a major drawback of arabinose-inducible promoters , carbon catabolite repression , ( CCR ) by glucose , we developed a high cell density culture ( HCDC ) , two-stage fed-batch protocol allowing us to reach cell densities exceeding 70 \xa0 g/L of dry cell weight ( DCW ) using glucose as carbon source .', 'The limitation of surface-display systems in biofuel cells to a single redox enzyme is a major drawback of hybrid biofuel cells , resulting in a low copy-number of enzymes per yeast cell and a limitation in displaying enzymatic cascades .', 'Limited secretion capacity remains a drawback of using Escherichia coli as the host for the production of recombinant proteins .', 'A problem with the use of Escherichia coli to produce foreign proteins is that although endogenously produced acetate is physiologically indispensable , it inhibits protein expression .', 'Foaming of the culture medium had not been encountered previously , but was a serious problem in pilot scale production due to the very rapid growth of a large volume of L. giganteum .', 'Therefore , reducing the level of FR900525 was a serious problem in the industrial strain A. In this study , we aimed to reduce the FR900525 production .']


Cluster  2161
['All patients could be successfully treated within two clinical appointments.', 'All patients were responders at post-treatment in case series.', 'The ablation procedure could be performed as planned in all 250 patients.', 'All patients completed the study protocol.', 'A complete clinical response was achieved by all of the patients.', 'At over fourteen weeks, all volunteers completed the study.', 'All the participants completed the\xa0rehabilitative treatment.']


Cluster  263
['It can be a serious problem , consisting of separation of the arytenoids with a fissure resulting from a defect in the fusion of the posterior cricoid cartilage lamina .', 'Scaphoid non-union , particularly following internal fixation , is a vexing problem .', 'It also presents as a troublesome therapeutic problem due to its sequelae of cicatrical stenosis .', 'A major drawback of tube salvage surgery is the significant risk of persistent trophoblastic tissue being left behind .', 'This nonrandomized prospective study included 52\xa0patients with uni-/bilateral dehiscence syndromes of the superior and/or posterior canal (SCDS/PCDS), diagnosed with high-resolution computed tomography (HR-CT) of the petrous bone.', 'Epiphora resulting from traumatic occlusion of the inferior canaliculus has long been a vexing problem .', 'This stenosis is a serious diagnostic and therapeutic problem being often the cause of lacking improvement or recurrence of radicular pains after operations for herniated nucleus pulposus .', 'The dissociation has only rarely caused a serious cosmetic problem , and then it has been markedly asymmetrical and has been improved by combined superior rectus recession and Faden procedure .', 'Canaloplasty is an effective and safe option for POAG with failed GFS but an intact SC.', 'Dehiscence syndromes of the semicircular canals are a\xa0relatively new group of neurotological disorders.']


Cluster  646
['With advances in radiology , anesthesia , antisepsis , and hardware technology , surgical treatment is now generally preferred , yet loss of elbow joint mobility can still be a vexing problem .', 'No statistically significant difference was determined between the groups in respect of the Q-DASH and grip strength scores preoperatively and at 6\xa0weeks and 3 and 6\u2009months post-injection.', 'Total wrist arthroplasty is still a\xa0rare procedure', 'Despite a small sample size, we found significant differences in migration between glenoid device designs.', 'A total of 19 patients (95%) showed no postoperative motor deficit; one suffered from akinesia due to supplementary motor area involvement and demonstrated a transient deficit with manifestation on the first postoperative day.', 'Regardless of the received postoperative treatment, range of motion was predominantly limited in the proximal interphalangeal and distal interphalangeal joints after 6\xa0weeks.', 'If safe, the duration of basal thumb joint distraction can be reduced to 6\u2009weeks, reducing patient burden.', 'All patients had good blood flow to the hand after intervention and none experienced complications during or immediately post-procedure.', 'Both implants showed consistently good functional and radiologic results without a significant difference and achieved an anatomic reconstruction of the humeral head geometry in the coronal plane.', 'A combined posterior lateral and anteromedial approach or other conservative treatments showed significant improvements in the activity of the elbow, MEPS, VAS, the excellent rate, and x-ray results.']


Cluster  83
['In many instances it can also be the first presentation of a serious urological problem .', 'The treatment of micturition disorders creates a serious problem for urologists .', 'Between January 2010 and September 2014, 1221 patients with urolithiasis were treated in Oyokyo Kidney Research Institute and Hirosaki University Hospital.', 'The high incidence of urinary tract cancer in the data presented here support the rationale for diagnostic work-up of patients with micro- or macrohaematuria.', 'Urolithiasis has high recurrent rate after surgical removal within 3\u2009years.', 'Seventy-four urolithiasis patients were randomly allocated to receive either LPR or placebo for 6\u2009months in a double-blinded manner.', 'Urothelial carcinoma (UC) is the most common genitourinary malignancy in China', 'Indeed , although urinary lithiasis has also been recorded for patients in Japan , the aetiology , incidence and spontaneous regression of this condition suggest that it is not a serious problem for this patient population .', 'The intention of this study was to verify if the intensive diagnostic procedures of haematuria patients is justified by detection of a significant proportion of genito-urinary tract cancers.', 'Lower urinary tract symptoms are not only a serious health problem but also a substantial sociologic issue affecting human beings and companion animals .']


Cluster  2085
['The changes in 24-hr BP were comparable between the groups.', 'The study revealed significant improvements in resting systolic blood pressure (SBP) of 4.', 'After establishing capnoperitoneum, HR, blood pressure, and PetCO2 were significantly increased in the HP group compared with the OP and LP groups (P\u200a<\u200a0.', 'Compared with rest, mean arterial pressure was significantly increased during PEI30% (+24±4\u2009mmHg, P<0.', 'Although no significant differences were identified in BP after the control session, after the experimental session, the trained participants presented lower values than the sedentary participants for systolic (124.', 'At 12-weeks, the fixed group had lower systolic BP and similar diastolic BP compared to the free group.', 'Our data suggest that lower ambulatory BP can be achieved, to a similar magnitude in young healthy women as well as men, with IRT; however, the BP-lowering effectiveness cannot be predicted by systolic BP reactivity.', 'The attainment of adequate BP control was similar in subjects with or without CKD (around 31%).']


Cluster  690
['These results may indicate a serious problem in the long-term treatment of CML with recombinant interferon .', 'LAHS can be considered when HLH patients have a diagnostic index\u2009≥2 points, so actively looking for evidence of lymphoma and effective chemotherapy may be necessary.', 'Immunophenotyping has a central role in CLL', 'Chronic lymphocytic leukemia ( CLL ) in association with glomerulonephritis ( GN ) and renal failure is a serious problem in terms of therapy .', 'The problem associated with lymphokine ( gamma-interferon , interleukin-2 , and tumor necrosis factor ) therapy in cancer is that high toxic doses of these lymphokines must be administered for any significant antitumor results .', 'III ) Primary CNS lymphoma ( PCNSL ): Combination of chemotherapy with high-dose MTX and radiotherapy improved survival of patients with PCNSL ; however , the neurotoxicity produced by this treatment modality is a serious problem in older patients .', 'Tumor lysis syndrome ( TLS ) , caused by the release of cellular components into the blood after rapid cell lysis , is a serious problem in patients with hematologic malignancies .', 'Compared to non-malignancy-associated HLH, LAHS patients had significantly elevated lactate dehydrogenase (LDH) levels, increased thickness of spleen, higher proportion of patients with lymphadenopathy and significantly decreased peripheral blood cell count.']


Cluster  373
['A retrospective chart review of 4,878 patients who underwent appendectomy at our institution from January 2008 to December 2014 was performed.', 'A total of 1321 appendectomies were performed during the study period, of which 849 were uncomplicated and 382 were discharged same day.', 'The role of the microbiome has been widely discussed in the etiology of appendicitis.', 'Prior appendectomy was an independent risk factor for the development of antibiotic-resistant bacteria in bacteremia from BTI.', 'A serious conundrum for surgeons : Stump appendicitis .', 'A total of 22 children, 3 controls and 19 appendicitis patients; 11 phlegmonous, 4 gangrenous, and 4 perforated appendices, were prospectively included.', 'Recent evidence has suggested that appendix plays a pivotal role in the development and preservation of intestinal immune system.', 'Patients presenting to a university teaching hospital with CT-verified uncomplicated simple appendicitis (appendiceal diameter no larger than 11\u2009mm and without any signs of perforation) were randomized to management with a no-antibiotic regimen with supportive care (intravenous fluids, analgesia and antipyretics as necessary) or a 4-day course of antibiotics with supportive care.', 'A prospective pilot study was conducted of children undergoing appendectomy for appendicitis.', 'Acute appendicitis due to a foreign body , without an anamnestic of either surgery or injury may cause a severe diagnostic dilemma .', 'Treatment failure rates in patients presenting with CT-confirmed uncomplicated appendicitis appeared similar among those receiving supportive care with either a no-antibiotic regimen or a 4-day course of antibiotics.', 'The aim of this study was to assess predictive factors for negative appendectomy and to evaluate the outcomes of negative appendectomy.']


Cluster  87
['Distal bypass is the first-line treatment for patients with critical limb ischemia (CLI).', 'However , necrosis in the distal portion resulting from ischemia is a serious problem , increasing the cost of treatment and hospitalization .', 'The primary objective of this study was to investigate whether the application of antithrombotic therapies affects the success rate of digit replantation.', 'Venous insufficiency after microsurgical replantation/revascularization remained to be a vexing problem for finger failure , despite the level of amputation .', 'A total 477 digits of 319 patients who received dextran with low-molecular-weight heparin, dextran with prostaglandin E1, or no antithrombotic therapy after replantation of complete amputated digits from January 1, 2012, to January 1, 2016, were included in this study.', 'These results add to the body of knowledge regarding outcomes after major amputation and could be useful in the education and consent of patients faced with major amputation.', 'This study presents a lower incidence of painful post-amputation neuroma to those published in the literature.', 'Critical hand ischemia can be treated with endovascular techniques.', 'Critical hand ischemia (CHI) can be devastating and may result in amputation.']


Cluster  431
['Retrospective, single-center, cross-sectional study of 1345 consecutive melanomas treated with WLE.', 'Retrospectively acquired dermoscopic and confocal images of patients with melanoma in tertiary referral academic centres: Skin Cancer Unit in Reggio Emilia and at the Melanoma Unit in Barcelona.', 'We assembled a retrospective cohort comprised of 562 cases of melanoma.', 'Retrospective, observational, descriptive study of patients diagnosed with multiple primary melanoma at a tertiary care hospital between January 1987 and March 2019.', 'To identify the frequency of and risk factors for positive or equivocal margins after WLE of cutaneous melanoma.', 'Nonpigmented metastatic melanoma in a two-year-old girl : a serious diagnostic dilemma .', 'This study was observational and included a small number of patients with melanoma.', 'From a total of 160 lesions analysed, 128 of 154 benign lesions received an EIS score of 0-6, giving a specificity of the EIS method for the diagnosis of melanoma of 83·1% [95% confidence interval (CI) 76·3-88·7].', 'The aim of our study was to investigate clinical and dermoscopic criteria of acquired longitudinal melanonychia in adults to identify the best predictors of melanoma using a multivariate analysis and to explore eventual new dermoscopic criteria for nail melanoma diagnosis.', 'Among 82 cases, 25 were diagnosed as nail melanoma and 57 as benign lesions (including 32 melanocytic nevi and 25 benign melanocytic hyperplasia).', '(a) Describe the margins of LM in detail by analysing LM in three zones, that is centre, edge and surround using reflectance confocal microscopy (RCM) and histopathology; (b) ascertain association of histological distance of LM and atypical melanocytic hyperplasia from the surgical margin with multi-recurrent (MR) disease and (c) identify features (clinical, dermoscopy, RCM and histopathology) associated with MR LM.', 'One genuine problem with using immunohistochemistry as the initial diagnostic technique is that the results may show staining patterns that can be regarded as consistent with the diagnosis of melanoma even when the diagnosis is incorrect , and the need for performing ultrastructural evaluation is never appreciated .', 'Despite prior anecdotal reports possibly linking multinucleated giant cells phenotype to more aggressive clinical course, we find that melanomas with multinucleated giant cells phenotype is not associated with shorter survival.', 'To identify the frequency of and risk factors associated with upstaging after wide local excision of primary melanoma.', 'This is a retrospective observational study conducted on 300 melanocytic lesions.', 'This is a retrospective observational study of two independent series, with a total of 79 primary melanomas, diagnosed in two independent University Hospitals in Spain, from January 2000 to December 2004.', 'Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition.', 'Patients presented with suspicious melanocytic lesions that were eligible for short-term SDDI (with no clear feature of melanoma on dermoscopy).', 'Retrospective, single center, cross-sectional study of 1332 consecutive in situ to stage T4a melanomas treated with wide local excision.', 'The overall rate of upstaging of melanoma was 3.', 'Prospectively collected study of 1416 cases of invasive melanoma of the trunk and proximal portion of the extremities was performed to evaluate long-term outcomes.']


Cluster  1583
['In the past , the area of Bujanovac , Medvedja and Presevo had been exposed to mass immigration ( especially due to the war in the territory of former Yugoslavia ) , which caused a serious problem for general practitioners , who had to be vigilant and ensure that all patients registered in their practice were fully immunized .', 'Lack of health insurance for immigrants in Japan is a serious concern for this population as well as for the Japanese health care system .', 'The number of patients with an immigration background in geriatric healthcare institutions in Germany is growing continuously', 'The prevention of diseases among migrants becomes a serious problem of public health of subjects of the Russian Federation .', 'Considering the high rate of intention to emigrate in the studied population ( 54.77 % ) , a lot of whom will emigrate if their situation is ready , it can be a serious problem for the health system in the near future in which it will face lack of skilled health workers , and so requires more attention of health sector authorities .']


Cluster  1980
['Hydroxyapatite ( HA ) coatings directly deposited by hydrothermal electrochemical technology ( HET ) onto carbon/carbon ( C/C ) composites exhibited a catastrophic failure occurring at the interface of the HA and C/C. To overcome this problem , a polyvinyl alcohol (PVA)/graphene oxide ( GO ) interlayer ( P/G interlayer ) was applied on the ( NH', 'The fungal infestation by   Drechslera   sp. in melons is a severe problem , and we demonstrate that electronic sensors based on carbon nanostructures are able to detect the presence of these fungi in melon .', 'The dispersion of carbon nanotubes ( CNTs ) into individual particles or small bundles has remained a vexing problem that limits the use of the excellent properties of CNTs in composite applications .', "Our results indicate that for solid surfaces coated by few-layer graphene in high Reynolds ( supersonic ) regimes , the outer graphene layers are confronted with delamination due to the high shear stress of airflow , which is a serious problem for the structure 's strength and durability .", 'The occurrence of barely visible impact damage ( BVID ) in aircraft composite components and structures being in operation is a serious problem , which threatens structural safety of an aircraft , and should be timely detected and , if necessary , repaired according to the obligatory regulations of currently applied maintenance methodologies .']


Cluster  705
['Cranial mononeuropathy is one of the not so common forms of diabetic neuropathy that often appears to be a serious problem from a diagnostic and therapeutic point of view .', 'Neuropathy of the cranial nerves , despite being a rare entity in diabetes mellitus , appears to be a serious problem from a diagnostic and therapeutic point of view .', 'Optic neuritis is a special challenge to the ophthalmologist', 'Optic neuropathy epidemics have proven to be a serious public health problem around the world .', 'Ophthalmoplegia , despite being a rare entity in diabetes mellitus , is associated with great anxiety for the patients and often appears to be a serious problem from a diagnostic and therapeutic point of view .', 'Anterior ischemic optic neuropathy may rarely occur after dental extraction.', 'Cross-sectional study of 46 patients with stable, incompletely recovered optic neuritis.', 'She was transferred to a tertiary center with a severe headache and a nonreactive pupil , raising concern for evolving third nerve palsy due to aneurysm .', 'Symptoms of multiple cranial neuropathies may cause great anxiety for these patients and often appear to be a serious problem from a diagnostic and therapeutic point of view .']


Cluster  812
['A cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition.', 'These results show that malnutrition is still a serious public health problem in Kenya and requires urgent attention .', 'Micronutrient deficiency remains a serious problem in Indonesia with approximately 100 million people , or 40 % of the population , suffering from one or more micronutrient deficiencies .', 'Micronutrient deficiencies have been a serious public health problem among women of reproductive age in low- and middle-income countries including India , adversely affecting maternal and child health and human capital outcomes .', 'Malnutrition is a serious problem , and malabsorption of nutrients is believed to be partially responsible for its prevalence .', 'Micronutrient deficiency has become a serious health concern in many countries and Sri Lanka is no exception .', 'Dietary intake in the third month postpartum and nutritional status during pregnancy close to term were assessed in Iranian urban uomen of low and middle socioeconomic status as part of a study investigating nutrition , hormonal status , and lactation in a population where lactation failure is a serious problem .', 'Malnutrition remains a serious public health problem , and thus , the development of novel treatment methods is highly essential .', 'Malnutrition is a severe problem of public health over all the world , particularly in Latin America .', 'The severity of hunger in mountain and hill districts of Mid- and Far-Western Development Regions is a serious concern .', 'Malnutrition constitutes a serious problem of public health .', 'Severe acute malnutrition is a serious public health problem , and a challenge to clinicians .', 'Malnutrition is a serious public health problem . The humanitarian community needs to adopt alternative strategies to improve food security and the nutrition status in Yemen .', 'The study concludes that maternal malnutrition is a serious problem in the study area and that there are contextual risk factors that could be addressed to partially tackle the problem .', 'This study indicates that undernutrition is a serious problem among rural Malawians aged 45 - 75 years .', 'Micronutrient malnutrition is a serious public health problem in developing countries , including Sri Lanka .', 'Malnutrition is a serious public health problem that has been linked to increase risk of morbidity and mortality in slums of Dhaka city and where the prevalence of malnutrition is very high .', 'The results indicate that malnutrition is a serious public health problem in the studied regions .', 'Malnutrition is a serious public health problem , particularly in developing countries , linked to a substantial increase in the risk of mortality and morbidity .', 'Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem .']


Cluster  329
['This may introduce a serious bias into psychiatric family study data , leading to overestimation of the strength of the tendency for mental disorders to " run in families . " Family studies that rely on the informant method in their diagnostic evaluations should be aware of this problem .', 'A drawback of existing tests is their poor ability to detect malingerers possessing more " sophisticated " knowledge of neuropsychological deficits .', 'At 6 weeks, there was a significant difference in favor of MCT+\xa0regarding decrease in delusion severity and improvement of self-reflectiveness (medium effect size), and a trend-wise difference regarding probability thresholds to decision.', '92 patients with current or past delusions were randomized to receive 12 twice-weekly sessions of either MCT+\xa0or a control intervention within a randomized controlled rater-blind design.', 'Such multi-purpose uses of terms may explain both the current problems associated with the Swedish forensic-psychiatric concept of a severe mental disorder and some of the shortcomings of DSM-IV .', 'A drawback of their construction is that neither has a clinically validated cutpoint to define a case of common mental disorder ( CMD ) .', 'Lower attendance rates in the control group possibly leading to unequal therapeutic effort; lower baseline delusion severity in the MCT+\xa0group.']


Cluster  1972
['Our pilot data showed OMM treatment bi-weekly for 6\xa0weeks improved motor function.', 'After intervention, the strength of the buccinator and the OOM in the experimental group showed statistically significant improvement.', 'There was an overall significant decrease in functional motor symptoms, general, physical, and reduced-activity fatigue (for all, p\u200a<\u200a0.', 'There were significant improvements in motor function scales (P< 0.', 'There were significant intervention effects, and large effect sizes (Cohen d) noted in locomotor (P = 0.', 'There was a significant reduction in all groups in the time factor for motor function (F\xa0=\xa012.']


Cluster  258
['The current antitubercular therapy ( ATT ) suffers from a drawback of longer duration that imposes a major challenge of patient non compliance and resistance development .', 'Of 811 patients, 156, 128, 125, 120, 114, 107, and 61 initiated the following AEDs: levetiracetam, lamotrigine, lacosamide, valproate, topiramate, carbamazepine, and phenytoin, respectively.', 'Both SC fondaparinux and oral edoxaban are effective in acute VTE.', 'Prospective observational study of consecutive patients treated by vascular physicians in the private sector with tinzaparin (131\u2009IU/Kg) once daily.', 'Tinzaparin at intermediate dose is an effective and safe treatment for SVT.', 'This controlled, multicenter study involved 93 HD patients on stable ESA therapy, who were randomized to either ViE-coated polysulfone dialyzer or to a low-flux synthetic dialyzer.', 'The ViE dialyzer can improve ESA response in HD patients.', 'Both travoprost and SLT can significantly reduce the IOP in patients with POAG and NTG.', 'Citalopram is a safe and tolerable medication in patients with acute IS, which could improve the outcome in these patients.', 'For most patients with chronic ITP, eltrombopag is not associated with clinically relevant increases in BM reticulin or collagen formation.', 'Prospective randomized study comparing the Stretta treatment with controls receiving PPIs.', 'Secondary prophylaxis with dalteparin is a cost-effective alternative to VKA for the prevention of recurrent VTE in patients with cancer.']


Cluster  471
['Ninety-two LBW infants with a median gestational age (GA) of 32.', 'The aim of this study was to investigate the effect of sex on survival and short-term outcomes of very low-birthweight infants (VLBWI) born in Japan.', 'Low birth weight ( LBW ) infants with reduced nephron numbers have significantly increased risk for hypertension later in life , which is a devastating health problem .', 'Extrauterine growth restriction remains a serious problem in prematurely born neonates .', 'TEG measurements from term neonates were no different when the neonates were delivered vaginally or by cesarean section.', 'Since renal failure becomes a serious problem after birth , timely infant delivery is essential to avoid loss of renal function .', 'Postnatal growth restriction remains a serious problem in very low-birth-weight infants .', 'Infants in the TSF were significantly heavier than those in the BLW group.', 'Pre-term birth and/or low birth weight ( PTLBW ) is a serious problem in developing countries .', 'Low birth weight ( LBW ) is a serious public health problem in low- and middle-income countries and a leading cause of death in the first month of life .', 'Extrauterine growth restriction ( EUGR ) remains a serious problem among very low birth weight ( VLBW ) infants and is a marker of severe nutritional deficit during the first weeks of life .', 'Postnatal growth restriction has been recently identified as a serious problem in preterm , especially extremely low birth weight neonates who are also at the highest risk for necrotizing enterocolitis ( NEC ) .', 'We conducted a prospective observational study among very low-birthweight infants born at Takatsuki General Hospital, Osaka, between March and October in 2010.']


Cluster  1661
['These biofilms entail a serious problem in daily clinical practice because of the great prevalence of implantable device-related infections .', 'Bacterial infection of biomaterials is a serious problem in the field of medical devices .', 'Biofilm-associated infections in the medical devices pose a serious problem to the public health and adversely affect the function of the device .', 'Although all routine bacterial cultures were negative, the prosthesis interface had both higher bacteria load and biofilm deposition compared with the intercapsular space (Mann-Whitney U test, p = 0.', 'Microbial contamination of the devices is a serious and widespread problem in surgery because it often causes devastating infections and loss of the implanted devices .', 'Candida biofilm can form on the surface of plastic materials ( silicon , polychloride vinyl , polymethacrylate methyl ) used to catheters , drains and dentures production that is why it is a serious problem in case of fungal infections in patients who during the diagnosis and treatment have contact with biomaterials .', 'Biofilm-associated implant infections represent a serious public health problem .', 'Biofilm formation on medical devices such as tracheostomy tubes ( TTs ) is a serious problem .', 'This matrix , together with cell proximity , confers many advantages to these microbial communities , but also constitutes a serious concern when biofilms develop in human tissues or on implanted prostheses .', 'Biofilm formation on medical implants and devices has been a severe concern that results in their impaired performance and life-threatening complications .', 'Bacterial infection associated with the use of medical or dental devices is a serious concern .', 'Infections resulting from the attachment of bacteria and biofilm formation on the surface of medical implants give rise to a severe problem for medical device safety .']


Cluster  792
['Mercury contamination is a serious environmental problem worldwide .', 'Mercury vapor poisoning is a serious and potentially fatal problem .', 'Methylmercury ( MeHg ) exposure is a serious problem of public health , especially in the Amazon .', 'The contamination of water surfaces by mercury is a dangerous environmental problem due to its toxicity , which leads kidney damage .', 'Mercury pollution is a serious problem in some areas of the southeastern United States .', 'Acute mercury vapour poisoning is a serious , potentially fatal but fortunately rarely encountered problem .', 'Mercury intoxication is a serious public health problem and a worldwide concern .', 'Mercury allergy is a serious health problem .', 'Mercury contamination in fish is a serious public health concern that contrasts with other health benefits of eating fish .', 'Environmental contamination caused by mercury is a serious problem worldwide .', 'Mercury is a highly toxic heavy metal and the ability of the neurotoxin methylmercury to biomagnify in the food chain is a serious concern for both public and environmental health globally .', 'Environmental contamination caused by mercury is a serious problem worldwide .', 'In the James Bay region of Canada , with the advent of extensive hydroelectric development , methylmercury contamination of fish has become a serious problem , having a direct impact on the Cree way of living .']


Cluster  144
['HC is a rare primary headache disorder belonging to the family of trigeminal autonomic cephalalgias (TACs)', 'One hundred and fifty one patients were selected, including chronic migraine (n°47), migraine without aura (n° 92) and migraine with aura (n° 12) sufferers.', 'Various studies report that non-pharmacological therapies and integrative therapies play a major role in the management of migraine headaches.', 'EMM is a common complaint in women evaluated for menstrual-related migraine (MRM), yet these migraines occur many days after the estrogen withdrawal that precipitates MRM.', 'To describe a randomized controlled trial protocol that evaluates the effectiveness of a multicomponent intervention in improving the outcomes (quality of life, disability, intensity, frequency and duration) of patients with migraine.', 'Migraine headaches occurred in 5 (3.', 'MWA accounts for about 30-40% of the total cases of migraine and is almost always preceded by visual disorders; and in rare cases migraine attacks are preceded by olfactory hallucinations which have not been so far recognized as a type of aura', 'WCT reduced pain and disability in patients with migraine, and the efficacy increased when the application was continued.', 'A randomized, cross-sectional, within subject approach was used to compare neuropsychological and electrophysiological evaluations from migrane-affected and healthy subjects.', 'This study aimed to assess the effectiveness and safety of percutaneous electrical nerve stimulation (PENS) in migraine treatment.', "Our menstrual migraine (MM) clinic's database was queried for patients with migraine, regular menses, and the locally used diagnostic code of EMM, signifying the patient's assertion that she had migraine at the end of menses as well as calendar data confirming that association.", 'This was an observational cross-sectional study on 8-15\xa0years old migraine patients.', 'Thirty-four patients with migraine (6 males, 28 females, average 36\xa0years old) were included.', 'Among the most recently seen 119 women in the clinic, 85 had both regular menses and a diagnosis of migraine, and were thus appropriate for evaluation.', 'We prospectively studied new patients referred to our tertiary headache center for migraine.', "A nursing intervention can lower the impact of migraines on the patient's life."]


Cluster  2039
['This case illustrates how a severe metabolic alkalosis can result from a significant ingestion of Gaviscon , and that such presentations can give rise to diagnostic dilemma .', 'Acid infusion did not induce dyspeptic symptoms with both placebo and sildenafil pretreatment.', 'The antidotal treatment of tabun acute poisonings still represents a serious problem and the development of new , more effective AChE reactivators to achieve the satisfactorily effective antidotal treatment of acute poisonings with tabun still represents very important goal .', 'This was a 28-day open-label trial, comparing initial acetaldehyde levels after alcohol ingestion to levels after 28 days of a nutritional supplement (Essential AD2).', 'The present trial was designed to study the effectiveness, safety, and tolerability of a nutritional supplement (Essential AD2).', 'Current evidence suggests sodium bicarbonate (NaHCO<sub>3</sub>) should be ingested based upon the individualised alkalotic peak of either blood pH or bicarbonate (HCO<sub>3</sub><sup>-</sup>) because of large inter-individual variations (10-180\xa0min).', 'Preliminary studies on the effects of antabus ( tetraethylthiuram disulfide ) in the therapy of alcoholic patients indicate that it is very valuable in providing a " chemical foundation " for sobriety , even in those with a severe , long term drinking problem .']


Cluster  700
['The potential presence of human pathogens in vegetables grown in soils contaminated with E. coli O157:H7 is a serious problem to our national food supply as the pathogen may survive on the leaf surface as they come in contact with contaminated soil during germination .', 'Foodborne diseases are a serious and growing problem , and the incidence and prevalence of antimicrobial resistance among foodborne pathogens is reported to have increased .', 'Foodborne illness outbreaks resulting from contamination of Escherichia coli O157:H7 remain a serious concern in food safety .', 'The emerging of antimicrobial-resistant foodborne bacteria is a serious public health concern worldwide .', 'The present findings clearly demonstrate that antibiotic-resistant bacteria in beef and milk pose a serious problem in South Africa .', "Changes in consumers ' habits have led to an increase of convenient LPFP with a relative long shelf-life ( at least 3 weeks ) which , on the other hand , may constitute a serious problem from a safety perspective since Listeria monocytogenes and sometimes Clostridium botulinum ( mainly type E ) may able to grow .", 'The contamination of enterotoxigenic Clostridium perfringens spores on food contact surfaces posses a serious concern to food industry due to their high resistance to various preservation methods typically applied to control foodborne pathogens .', 'Foodborne illness caused by L. monocytogenes is a serious public health concern because of the high associated mortality .', 'Superbugs in food : a severe public health concern .', 'Bacterial spores are the most resistant form of life known on Earth and represent a serious problem for ( i ) bioterrorism attack , ( ii ) horizontal transmission of microbial pathogens in the community , and ( iii ) persistence in patients and in a nosocomial environment .', 'Food-borne pathogens are a serious human health concern worldwide , and the emergence of antibiotic-resistant food pathogens has further confounded this problem .', 'Human illness due to contamination of food by pathogenic strains of Escherichia coli is a serious public health concern and can cause significant economic losses in the food industry .']


Cluster  2058
['if d exists -LCB- e -RCB- otherwise . much of the efficiency of XPath expressions can be lost through the necessity of resolving XLinks at every child or parent step of the expression', 'if d exists -LCB- e -RCB- otherwise . much of the efficiency of XPath expressions can be lost through the necessity of resolving XLinks at every child or parent step of the expression', 'A drawback to using XPath to query a hierarchy which is serialised to multiple annotation files , is that much of the efficiency of XPath expressions can be lost through the necessity of resolving XLinks at every child or parent step of the expression']


Cluster  940
['Consequently , a potential drawback of NK-cell targeted modulatory interventions is that they can potentiate the suppressive NK cell effect on virus-specific T cells , which further causes impairment of exhausted anti-viral T cell functions .', 'In conclusion , the ability of Tregs to promote the Th17/neutrophil-mediated pathway of rejection that we have described should be considered as a potential drawback of Treg-based cell therapy .', 'Toll-like receptors 2; 4 (TLR2;4) are an essential component of the innate immunity and play an important role in immune-surveillance and immune response to various microorganisms', 'While immunosuppressants are known to achieve control and lower steroid dependence in T2LR , the prospect of managing a severe T2LR in conjunction with COVID-19 , with the concern of worsening COVID-19 with long-term immunosuppression has not previously been encountered .', 'A number of studies have demonstrated the role of CX3CR1 in regulating the migration of monocytes into peripheral tissue and their transformation into dendritic cell (DC)', 'It is generally accepted that the difficulty in obtaining a sufficient number of functional dendritic cells ( DCs ) is a serious problem in DC-based immunotherapy .', 'At viral set-point, the memory B cell compartment in treated patients demonstrated significantly lower fractions of antigen-primed, activated, memory B cells (p = 0.', 'The relative and absolute numbers of Th22 and Th17 cells were significantly higher in patients with acute gouty arthritis than in patients with IG and healthy controls.']


Cluster  2139
['Based on literature review , this article provides a brief description of the Brazilian legislation policy regarding intellectual property and biodiversity access , places natural drug discovery in context , analyzes patent cases and highlights critical key issues responsible for the drawback of the whole process that has a direct impact on industrial and research development , nature protection and benefit share with our society .', 'Wounds , burns , cuts , and scarring may cause a serious problem for human health if left untreated , and medicinal plants are identified as potentially useful for wound healing .', 'Ethnobotanical research has demonstrated that several wild food plants (WFP) are used for medicinal purposes', 'Dengue represents a serious social and economic public health problem ; then trying to contribute to improve its control , the objective of this research was to develop phytoterapics for dengue treatment using natural resources from Caatinga biome .']


Cluster  1087
['Computer mediation of communication potentially diffuses responsibility ; imposes a temporal asynchrony between signified intent and audience response ; and reduces the empathy that might motivate observers or witnesses to intervene and render assistance , factors that make online baiting a serious social , legal and technological problem .', 'Bank robberies are becoming a serious problem in Italy .', 'Recently telecom fraud has become a serious problem especially in developing countries such as China .', 'E-mail systems and online social media platforms are ideal places for news dissemination , but a serious problem is the spread of fraudulent news headlines .', 'Hate speech has long posed a serious problem for the integrity of digital platforms .']


Cluster  858
['These data indicated that fortified and non-fortified milk are excellent options to increase serum VA, zinc, and iron concentration in schoolchildren.', 'Iron deficiency anemia is a severe public health problem in developing countries .', 'Our objective was to compare iron status at 18 months and growth from 6 to 18 months in rural poor toddlers fed 3 different complementary foods.', 'There are few data derived from communities where iron deficiency is common and anaemia is a serious health problem .', 'That is why iron deficiency has a severe impact on the lives of different organisms , including humans , becoming a major concern , especially in developing countries where access to adequate nutrition is still difficult .', 'School feeding programs that integrate fortified foods with deworming could reduce anemia burden with important implications for learning, health, and well-being.', 'Iron deficiency anemia is a serious health problem that affects the physical and cognitive development of children .', 'Iron-deficiency anaemia ( IDA ) is a serious health problem in neonatal piglets and is controlled by routine application of iron in various formulations .', 'A significant problem in diagnosing infants and young children with iron deficiency ( ID ) and iron deficiency anemia ( IDA ) is that it is not clear how the biochemical markers used correspond to physiological outcomes such as growth , neurodevelopment and morbidity .', 'The study of iron metabolism is essential in nutritional sciences as iron deficiency is one of the most common nutritional deficiencies in humans and represents a serious health problem worldwide .', 'There are few data derived from communities where iron and folate deficiency is common and anaemia is a serious health problem .', 'Iron deficiency anaemia is a serious problem among Pakistani children .', 'The high prevalence of depleted iron stores in nulliparous women is a severe public health problem that requires attention .', 'Deficiency of micronutrients , especially iron and zinc , has been a serious malnutrition problem worldwide in human health .', 'Iron fortified cereal improved iron status of poor rural toddlers but was also associated with systemic inflammation which was likely to impair their growth.', 'Iron deficiency represents a serious health concern for women , particularly pregnant ones .']


Cluster  839
['A total of 40 patients were enrolled, each treated by the following DCS regimen: docetaxel 40 mg/m<sup>2</sup>, cisplatin 60 mg/m<sup>2</sup> on day 1, and S-1 80 mg/m<sup>2</sup> on days 1-14, repeated every four weeks, for a maximum of three cycles.', 'One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group.', 'The objective of this study was to assess whether efinaconazole together with laser would result in greater clinical and mycologic cure and lower rate of relapse compared to efinaconazole alone.', 'Although its treatment outcomes have improved with the use of glucocorticoids , alkylating drugs , and novel agents , including proteasome inhibitors ( bortezomib and carfilzomib ) and immunomodulatory drugs ( thalidomide , lenalidomide , and pomalidomide ) , relapse remains a serious problem .', 'A retrospective review was conducted of 59 consecutive patients who underwent bi-/tri-modal treatment with induction chemotherapy, EPP, and radiation therapy from July 2004 to August 2013 at Hyogo College of Medicine (Nishinomiya, Japan).', 'Indeed if new balistic assessment of the disease improves the efficacy of radiotherapy and new combined chemotherapy have shown antitumoral responses , surgical strategy takes part in the armamenterium for this disease and combined with others therapeutic modalities seems to be a raisonnable approach despite the lack of prospective , comparative , randomized study and the drawback of current staging .', 'According to our data, FAEs as monotherapy or in combination with phototherapy or methotrexate are safe and beneficial for long-term clinical use.', 'This trial did not show superiority of UFT maintenance in non-selected patients responding to fluorouracil-based first-line chemotherapy.', 'We can conclude that pegfilgrastim alone is at least equally successful as filgrastim alone for the PBSC mobilization in newly diagnosed myeloma patients.', 'A total of 42\xa0myeloma patients were prospectively enrolled in the study: 21\xa0received filgrastim, 21\xa0pegfilgrastim.']


Cluster  475
['We conducted a retrospective cohort study of patients undergoing cardiac transplant (HTx) for ATTRwt at a single institution.', 'Cardiomyopathy is a severe and life-threatening problem , for which cardiac transplantation is the only therapeutic option .', 'While our experience is of a far lower incidence of rejection than registry data , rejection remains a serious problem after paediatric heart transplantation .', 'Graft coronary artery disease , a serious problem after orthotopic heart transplantation ( OHT ) , has multifactorial etiologies with dyslipidemia as one of the major risk factors .', 'Cardiovascular disease is a serious problem of liver transplant ( LT ) recipients because of increased cardiovascular risk due to immunosuppressive therapy , higher age , intraoperative risk and comorbidities ( such as diabetes and nicotine abuse ) .', 'Among the various complications of heart transplantation ( HTx ) , the vasculopathy of the allograft ( CAV ) , a phenomenon of chronic rejection , is still a serious problem .', 'The risk of PLOS after heart transplantation can be determined at the time of transplant.', 'The shortage of donor hearts is a serious concern since the population affected by heart failure is constantly increasing .', 'Severe cardiac allograft rejection remains a serious problem despite the advances of cyclosporine-based immunosuppression .', 'Hemodynamically significant acute graft rejection in pediatric heart transplant recipients is a devastating problem with poor short- and long-term outcomes .', 'End-stage allograft failure following cardiac transplantation is a devastating problem , and retransplantation offers the only chance for survival .', 'A severe shortage of donor hearts is the most serious problem , especially in infants who can not be supported by assist devices .']


Cluster  1444
['Tuberculosis remains a serious health problem worldwide .', 'Tuberculosis remains a serious global health problem involving one-third of the world population .', 'Tuberculosis continues to be a serious problem in public health even thought eh causative bacillus was discovered over 100 years ago .', 'Despite all improvements in modern medicine , tuberculosis is still a serious public health problem .', 'Tuberculosis continues to be a serious public health problem worldwide .', 'Tuberculosis is a serious public health problem worldwide .', 'Tuberculosis ( TB ) is a serious public health problem worldwide .', 'Tuberculosis historically was a major impetus for the development of thoracic surgery , and it remains a serious health problem of global proportion .', 'Tuberculosis is a widespread infectious disease that still remains a deadly global health problem and a condition that is life-threatening if misdiagnosed .', 'Tuberculosis ( TB ) is a serious public health problem in many parts of the world .', 'Tuberculosis is considered a serious public health problem .', 'Tuberculosis ( TB ) is a serious global health problem , although it is easily preventable and curable .', 'Tuberculosis ( TB - Mycobacterium tuberculosis ) is an ancient infectious disease that has appeared once again as a serious worldwide health problem and now comprises the second leading cause of death resulting from a single infection .', 'Tuberculosis remains a severe public health problem worldwide .', 'Tuberculosis is still one of the most common infectious diseases along with HIV and malaria and therefore represents a serious problem in the health sector .', 'Pulmonary tuberculosis is currently considered a serious health problem worldwide .', 'Tuberculosis ( TB ) has reappeared as a serious public health problem .', 'Tuberculosis ( TB ) remains a serious public health problem despite the great scientific advances in the recent decades .', 'Tuberculosis is still a serious problem in both developing and developed countries .', 'The outbreak of tuberculosis also has been increasing , and has become a serious social problem .', 'Tuberculosis continues to be a serious health problem worldwide .', 'Tuberculosis may be as old as mankind and continues to be a serious medical problem today .', 'Tuberculosis ( TB ) continues to be a serious global health problem .', 'Tuberculosis ( TB ) is a serious public health problem worldwide .', 'Tuberculosis remains a serious human public health concern .', '< sec > < title > BACKGROUND</title > Tuberculosis ( TB ) remains a serious health problem worldwide .', 'Tuberculosis ( TB ) remains a serious global public health problem that results in up to 2 million deaths each year .', 'Pulmonary tuberculosis (PTB) is a major health and economic burden', 'At a time when reduction in Federal support for tuberculosis control is being considered , it is important to realize that the disease remains a serious medical problem and financial burden in the United States .', 'Tuberculosis ( TB ) is a chronic bacterial disease , which despite the presence of effective drug strategies , still remains a serious health problem worldwide .', 'Tuberculosis ( TB ) is a serious health problem causing 1.5 million deaths worldwide .', 'Pulmonary tuberculosis is a serious public health problem in Brazil .', 'Tuberculosis ( TB ) is a serious public health problem .', 'According to the official domestic statistics pulmonary tuberculosis continues to be a serious problem for the Russian Federation .', 'Tuberculosis is an infectious disease , which is the leading cause of mortality and morbidity and is still a serious health concern .', 'Tuberculosis has re-emerged as a serious public health problem in recent years .', 'Tuberculosis ( TB ) has remained a devastating global public health problem .', 'Tuberculosis is a serious problem of public health .', 'Tuberculosis ( TB ) remains a serious health problem responsible to cause millions of deaths annually .', 'Tuberculosis is still a serious public health problem , with 10.8 million new cases and 1.8 million deaths worldwide in 2015 .']


Cluster  1896
['However , a major problem with polymer-protein conjugation is that the polymers drastically reduce the bioactivity of the modified protein .', "An advantage in one sense , but a drawback of PLGA use in another , is that drug delivery systems made of this material can provide a wide range of dissolution profiles , due to their internal structure and properties related to particles ' manufacture .", 'One major problem with PLGA microspheres is that they develop an acidic microclimate as the polymer degrades , lowering the intraparticle pH , and potentially damaging the DNA .', 'One limitation with chitosan and its derivatives like hmC is that these polymers are soluble in water only under acidic conditions ( because the pKa of chitosan is about 6.5 ) , which could be undesirable for biomedical applications .', 'However , limited availability as well as variations in the properties of the derived chitosan is a serious drawback of utilizing marine sources for chitosan production .', 'The problem associated with mixtures of fillers and polymers is that they result in mechanical degradation of the material ( polymer ) as the filler content increases .', 'A drawback of using SAPs lies in the formation of macropores when the polymers release their absorbed water , leading to a reduction of the mechanical properties .', 'A serious problem in this connection is the poor heat conductivity of polymers .', 'However , one problem with soft elastic materials in vivo is that the elastomers may degrade with time .', 'However , a major drawback of tissue engineering approaches that utilize synthetic polymers is the persistence of polymer remnants in engineered tissues at the end of culture .']


Cluster  1043
['Initially , all words except the predicate itself are treated as argument candidates . it only applies to parse-scoring functions with an arc-factored component', 'While this retains the coherence of the model , the restriction to pairwise predicates', 'The problem is that the non-contiguous elements in a verbchain are assigned into a single node while the subject in between belongs to its own node', "If its morphological tag contains the symbol for negative verb , a new node is created with the lexical -LRB- trlemma -RRB- value ` Neg ' and functor ` RHEM ' -LRB- rhematizer , i.e. nonterminal symbols encode too general information which weakly discriminates syntactic ambiguities", 'Not all occurrences of a nominalized predicate need to be accompanied by a support verb . the user may not find the exact sign ( or version of a sign ) that is needed for a particular sentence', 'Its main drawback is that important structural information related to interargument dependencies is neglected', 'DS-TTR tree nodes include a field head in all RTs . many verb reorderings are still missed', 'MPCT must be included in SALT-1 for both pairs , because the only over-generating ungrammatical sentences due to its “almost-free” alignment', 'However , a potential shortcoming of this model is that it can not represent the link between arguments of a verb', 'In turn the Goal is computed as if it were an obligatory semantic role like the missing Agent of passivized structures . it will add complexity']


Cluster  1555
['Diagnosis and management of the patient with pulmonary embolism remains a vexing clinical problem .', 'Pulmonary thromboembolism (PTE) is a very common condition with high mortality.', 'Pulmonary embolism is also a serious problem that occurs in more than 500,000patients per year , of whom approximately 200,000will die .', 'The Pulmonary Embolism Response Team ( PERT ) is a multidisciplinary team that quickly evaluates , coordinates diagnosis , and optimizes management for patients with pulmonary embolism ( PE ) , a serious public health problem .', 'Although massive pulmonary tumor embolism occurs relatively rarely , it can be a catastrophic problem .']


Cluster  289
['Mean platelet volume ( MPV ) may be a useful parameter for inflammatory conditions , in differentiating between non-specific abdominal pain ( NSAP ) and conditions requiring surgery , or early diagnosis of abdominal pain as a serious problem for emergency services .', 'All platelet function tests detected treatment effects in some dogs and may have utility for monitoring therapy.', 'The platelets are the most heterogeneous cellular elements of the blood in size whereas larger platelets have more granules that make them more reactive rather than their smaller counterparts.', 'Platelets should not be argued only with their concentration, but it would be appropriate to evaluate with their yielded concentration and volume with MPV together while comparing PRP preparation protocols and kits.', 'Platelet-rich plasma (PRP) is considered as a growing modality for tissue regeneration and a developing research area for clinicians and researchers.', 'Platelet count is used as a prophylactic platelet transfusion trigger, although evidence suggests that it is a poor predictor of bleeding.', 'For patients planned for open repair of a rAAA, we observed no significant effect of early administration of platelets with regard to post-operative complications and stay in the ICU or in hospital and also no significant effect on mortality.', 'Intra-device variability was low for TEG PM and MP, but the two point-of-care devices measuring platelet function correlate poorly with each other in injured trauma patients.', 'Acute normovolemic hemodilution protects the platelets from the untoward effects of cardiopulmonary bypass and offers an important autologous blood product that improves hemostasis at the conclusion of surgery.', 'A major drawback of fibrinolysis is the activation of platelets leading to a high rate of re-occlusion .', 'The study suggests high variability of PMPs and activated platelets in platelet components prepared using different processes.', 'In a prospective study design, patients were randomised to receive platelets (intervention; n\u2009=\u200961) or no platelets (control; n\u2009=\u200961) before transport to vascular surgery from 11 local hospitals.', 'Inadequate responses to platelet transfusions ( i.e. , platelet transfusion refractoriness [ PLT refractoriness ] ) are a serious problem .', 'To evaluate the effects of aspirin, clopidogrel, or combination therapy using 3 platelet function tests: Multiplate Analyzer (MP), Platelet Function Analyzer-200 (PFA), and Plateletworks (PW).', 'The median platelet aggregation to adenosine diphosphate during a drug-free baseline was 10Ω (2.', 'The aim of this study was to investigate whether autologous platelet-rich plasma (A-PRP) could accelerate and improve wound healing after cutaneous reconstruction for tissue loss secondary to soft tissue infection.', 'The combination of A-PRP/thrombin gel and an STSG significantly improved clinical outcomes and shortened the wound healing time.', 'A major drawback of the use of these PCs is the progressive increase of P-selectin-positive platelets during storage .', 'Platelet function testing in critically ill ACS patients identified patients at high risk for early ST and might be beneficial for risk stratification.', 'This study examines the clinical utility of the level of increased platelet distribution width (PDW) as a predictor of outcome in patients with traumatic brain injury.', 'This study was aimed to establish a novel strategy based on the surface plasmon resonance (SPR) technology for platelet compatibility testing', 'Both the percentage and number of PMPs were higher in platelet components prepared using the Amicus instrument (2.']


Cluster  2184
['During tonsillectomy, one of the key concerns is establishing adequate haemostasis', 'Paediatric tonsillectomy is a common procedure and one of the first skills acquired by surgical trainees.', 'Randomized, double-blind, controlled trial comparing postoperative pain in 132 children between the ages of 5 and 12 years undergoing tonsillectomy having bilateral closure, unilateral closure or non-closure of the tonsillar fossa.', 'These results showed that reducing the exposure of the tonsillar fossa after the removal of the palatine tonsils was not an effective method for postoperative pain relief in children.', 'Data were collected on all tonsillectomies performed by surgical consultants (n = 6) and trainees (n = 10) at affiliated hospitals over a nine-month period.', 'Our data suggest that experience of the surgeon may have greater bearing on post-tonsillectomy bleed rates than the technology used.']


Cluster  2222
['Our results support that accelerated expansion can be achieved in a 4-month-old orbit reversing the effects of anophthalmia.', 'Retrobulbar hematoma is a rare complication after the repair of an orbital wall fracture, but the caution is required because the condition can cause blindness', 'Corneal astigmatism is a severe postoperative problem in foveal translocation surgery .', 'Postoperative eyelid height stabilized 1\xa0month after surgery.', 'A retrospective study was performed of consecutive patients with hypertelorbitism, undergoing hypertelorbitism correction between 2007 and 2014.', 'Persistent metamorphopsia , particularly aniseikonia , is a troublesome problem which may occur after epiretinal membrane ( ERM ) surgery .', 'Postkeratoplasty glaucoma is a serious sight-threatening problem that is likely to remain with us for the foreseeable future .', 'Post-operative diplopia in adolescents and adults represents a serious problem , especially in susceptible patients .']


Cluster  681
['Emergence of lamivudine-resistant variants , with amino acid substitutions in the Tyr-Met-Asp-Asp ( YMDD ) motif of hepatitis B virus ( HBV ) reverse transcriptase , is a serious problem in antiviral therapy .', 'We conclude that codon usage problems are unlikely to constitute a serious problem for expression of BVDV proteins in BHV1 vectors .', 'However , the emergence of drug-resistant strains during therapy is a serious problem , and the susceptibility of resistant strains to interferon ( IFN ) , as well as the details of the emergence of mutant strains in vivo , is not known .', 'Ever since the discovery of RNAi in mammals , the interferon response has been a feared problem .', 'Type 1 interferons ( IFNs ) have been shown to be efficacious against hepatitis C virus ( HCV ) , hepatitis B virus ( HBV ) , and some cancers with a significant drawback of short drug exposure .', 'Hepatitis B virus ( HBV ) is a serious public health problem in need of better treatment options , and aspects of its life cycle make it an excellent target for RNAi-based therapeutics .']


Cluster  456
['Acute ischemic stroke ( AIS ) has become a serious health problem in many countries because of its poor outcome and worsening epidemic trend .', 'Stroke is a serious health problem and is chiefly a disorder of the elderly population .', 'In the Latin American context , stroke mortality rates in Costa Rica are low but still represent a serious public health problem by the high mortality , morbidity and disability that they cause , despite a downward trend .', 'Stroke continues to be a serious socioeconomic problem in the industrialized countries .', 'In Latin America , the cerebrovascular disease is considered a catastrophic public health problem .', 'This study concludes that hemorrhagic stroke is indeed a serious health problem in Hong Kong .', 'Stroke , broadly subdivided into ischemic and hemorrhagic subtypes , is a serious health-care problem worldwide .', 'Our results show that stroke is a significant public health concern in Rwanda.', 'Stroke is a serious global health care problem .', 'Stroke is the leading cause of long-term disability.', 'Acute ischemic stroke ( AIS ) is a major cause of mortality and disability and remains a serious and significant global health problem .', 'Ischemic stroke is a serious public health problem worldwide .', 'BACKGROUND Stroke is a serious health problem all over the world .', 'Stroke is a serious health problem , given it is the second leading cause of death and a major cause of disability in the European Union .', 'Ischemic stroke remains a vexing public health problem .', 'Ischemic stroke ( IS ) still constitutes a serious problem for public health worldwide .', 'Stroke represents a severe and growing health problem in the general population .', 'The number of stroke patients is increasing , and stroke represents a serious problem from the viewpoint of the national medical economy .', 'Stroke has become a serious public health problem in China .', 'Review of a database of a population study on the incidence, 30-day case fatality rate, and prognosis of stroke performed in a northern Chilean city between 2000 and 2002.', 'Ischemic stroke has become a serious public health problem , which is in need of advanced research on the prevention and treatment .', 'Stroke is a devastating condition with recognized challenges in identifying effective prevention programs .', 'Stroke is the leading cause of mortality and disability worldwide', 'Stroke is a serious health problem in many countries .']


Cluster  1254
['Firearm-related violence is a significant public health issue in the US', 'Consequently , reducing the mortality and complication rates from firearm injuries is still a serious problem .', 'Gun deaths and injuries in Canada are a serious public health problem , claiming more than 1200 lives each year and resulting in over 1000 hospitalizations .', 'Firearm injuries , many of which involve the hand , wrist , or forearm , pose a serious public health concern in the United States in both medical and economic terms .', 'Firearm-related deaths and injuries are a serious public health problem in California and the United States .', 'Gun violence is a serious public health concern , yet risk factors for gun violence involvement remain understudied .', 'Pediatric firearm injuries are a serious and growing public health problem , constituting the second leading cause of death in children and adolescents in the United States .', 'Background Firearm-related deaths are a serious public-health problem in South Africa , which has the second-highest rate of firearm-related deaths in the world .']


Cluster  105
['This study was developed as a randomized, placebo blind clinical trial.', 'A prospective, randomized, double-blind study was conducted.', 'A single-blind (evaluators were blinded to subject allocation) randomized trial was conducted.', 'A randomized controlled assessor-blind trial was carried out.', 'This was a prospective, double-blind, placebo-controlled, randomized clinical trial.', 'A prospective, randomized, single-blind, sham-controlled study was conducted.', 'Randomized, controlled, single-blinded study was performed.', 'This was an evaluator- and subject-blinded split-face study.', 'The study design was a split-mouth, randomized, blind clinical trial.', 'A preliminary double-blind, randomized, placebo-controlled trial was conducted.', 'This was a single-blind crossover repeated-measure study.', 'A randomized, double-blinded, placebo-controlled clinical trial was proposed.', 'A double-blind, parallel-group, placebo-controlled, randomized, controlled trial was performed.', 'A single-blind randomized control trial was conducted.', 'This is a prospective, randomized, double-blind, placebo-controlled, parallel study.', 'The study design was a split face, right-left, assessor-blinded, randomized controlled study.', 'A double blind, randomized, placebo-controlled trial was conducted.', 'Single-blind experiments were performed.', 'Single-blind randomized clinical trial was performed.', 'Single-blind, post-test randomized controlled trial.', 'Randomized single-blinded study.', 'Open randomized monocentric study.', 'This study was designed as a 5-week, randomized, single-blind.', 'Single-blinded placebo-controlled cohort study.']


Cluster  774
['A drawback of tandem mass tags are that the co-isolation and co-fragmentation of labeled peptide precursors can result in chimeric tandem mass ( MS/MS ) spectra that can underestimate the fold-change expression of each peptide .', 'Limited spectral resolution in the proton dimension of NMR spectra is a severe problem in intrinsically disordered proteins .', 'A major drawback of macromolecular NMR is its size limitation , caused by slower tumbling rates and greater complexity of the spectra as size increases .', 'Thus , we show that single-molecule force spectroscopy with a refined statistical analysis is a potent tool for the analysis of protein-RNA interactions without the drawback of ensemble averaging .', 'This is a serious problem for the obtention of correct and reproducible values of such important parameters as the molecular area of gangliosides , their electrostatic potential in oriented interfaces , and their interactions with other lipids and proteins .', 'A notable drawback of NMR spectroscopy is its inherently low sensitivity : 95 % of the measuring time consists solely of idle delays during which nuclei regain their Boltzmann equilibrium .', 'A serious drawback of the carrier ampholyte isoelectric focusing is the undetermined ionic strength at which the proteins separate .', 'It is possible that amide proton protection might occur during folding either by a non-specific mechanism , such as a hydrophobic collapse , or by the formation and later breakdown of non-native secondary structure ; either event would pose a serious problem for interpretation of the results .', 'Direct mass spectrometric characterization of interactions between proteins and small hydrophobic ligands often poses a serious problem due to the complex instability in the gas phase .', 'Atomic force microscopic studies demonstrate that PDC-109 effectively prevents the fibrillation of insulin , which is of considerable significance since amyloidogenesis has been reported to be a serious problem during sperm maturation in certain species .']


Cluster  1152
['Although rare , the failure to the latest-generation regimens ( grazoprevir/elbasvir , sofosbuvir/velpatasvir , pibrentasvir/glecaprevir ) represents a serious clinical problem , since the data available in the literature on the virological characteristics and management of these patients are few .', 'Foscarnet is widely used for the treatment of acyclovir-resistant herpesvirus infections , and foscarnet-resistant herpesvirus infections are a serious concern in immunocompromised patients .', 'The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern .', 'The frequency of patients who reached sustained virological response (SVR) was increased in patients with T/T at nt - 443 than in those with C/C or C/T.', 'Direct-acting antiviral agents (DAAs) have increased the sustained viral response rate with minimal adverse effects and short treatment duration.', 'We found that despite the introduction of the breakthrough designated triple therapies with telaprevir or boceprevir in 2011, there was no increase of prevalence or incidence between 2010 and 2011.', 'Resistance to all of these antiviral drugs may induce a severe problem in this patient cohort .']


Cluster  1965
['This randomized clinical trial included 90 patients of either sex, between 18 and 70 years undergoing major surgeries.', 'Ninety-three adult patients scheduled for oral and maxillofacial surgery were enrolled in this prospective study.', 'This randomized, single-blinded, prospective study will be conducted in patients undergoing head and neck surgery.', 'Results for the focus group of independent plastic surgeons and 377 members of the public were retrieved (n = 391).', 'Patients scheduled for implant or periodontal surgery were included in the study.', 'This study was a single-center, parallel-group randomized controlled trial conducted on 32 female patients suitable for upper blepharoplasty.', 'In all, 33 patients (13 females and 17 new accesses) were randomized to metal group (n\u2009=\u200917) and plastic group (n\u2009=\u200916).', 'All individuals who agreed to maxillofacial prosthetics after surgery for oral cancer were enrolled.']


Cluster  661
['A total of 148 patients (6-14 years of age; mean, 9.', 'We analyzed 126 patients aged 2-16 years (median, 7.', 'In total, 33 Tunisian patients (age, 2.', 'One hundred and eighteen patients aged four-11\u2009yr were recruited, 60 in the TAB Group and 58 in the MDZ Group.', 'Forty-four patients (3-19years) were studied.', 'Twenty-nine patients (median age: 13.', 'Patients were 102 cases; 62 were males, with age range 18days to 12years.', 'In this study, 432 patients were observed from 2000 to 2013.', 'Sixty patients were studied.', 'Fifteen patients (aged 12-17) were included in the study.', 'Twenty males treated with MPH (mean age, 8.', 'Forty-one patients were studied.', 'Fifty-two patients with a median age of 10.', 'This study included 54 patients: 28 (52%) girls and 26 (48%) boys.']


Cluster  2388
['Modified CIMT combined with TR may be more effective than mCIMT alone in improving upper-limb function and ADLs in patients with early stroke.', 'Implementation of a standardized protocol resulted in a significant reduction in time to recanalization for patients with an ischemic stroke.', 'Preceding use of IVT was not an independent predictor of favorable outcome in patients with acute stroke treated with MT and complication rates did not differ whether or not IVT was used.', 'A diabetes-specific formula may improve acute-term glycemic control in severe acute ischemic stroke patients.', 'WTAWD could be effective for patients with stroke.', 'Intra-arterial therapy (IAT) is most effective when performed rapidly after ischemic stroke onset.', 'Patients with cryptogenic stroke referred between August 2014 and February 2017 had ILRs implanted.', 'These results suggest that the CAHAI, although designed for use in the stroke population, can be used reliably in the ABI population.', 'This large-scale, controlled trial indicated that CG may be a useful treatment in the management of post-stroke patients.', 'We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device.', 'We found that triaging from a primary stroke center after CTP RAPID was feasible and significantly reduced the door to puncture time without any significant delay in the transfer process.', 'This trial will assess the safety and efficacy of Watchman in this challenging population of high-stroke risk AF patients.']


Cluster  178
['Laryngopharyngeal reflux symptoms assessed with the reflux symptom index can overlap with non-allergic rhinitis symptoms.', 'We prospectively analyzed esophageal sensitivity and esophageal mucosal integrity in GERD patients with and without BE and healthy subjects.', 'Patients with severe reflux esophagitis unresponsive to standard medical therapy constitute a vexing clinical problem .', 'Esophageal hypersensitivity to acid is less pronounced in BE patients than in GERD patients without Barrett.', 'In the 11 patients, median reflux index (percentage of the total monitoring period during which recorded pH was <4.', 'In this study , we considered that microscopic esophagitis does not always accompany reflux , and the lack of reliable diagnostic histologic criteria is still a serious problem for pathologists .', 'To determine if adding histology as a criterion and excluding patients with epigastric pain enhances the diagnosis for GERD.', 'Patients with frequent upper gastrointestinal symptoms who had not taken a proton pump inhibitor in the previous 2 months and who had evaluable distal oesophageal biopsies were included (Diamond study: NCT00291746).', 'Approximately 20-40% of patients with gastroesophageal reflux disease (GERD) are refractory to proton pump inhibitor (PPI) treatment.', 'Gastroesophageal reflux disorder ( GERD ) is a serious health problem in the Western world , with prevalence rates between 9 and 42 % .', 'Proton pump inhibitors are effective at reducing heartburn.', 'Gastroesophageal reflux disease is a serious clinical problem , which can significantly impair health-related quality of life , thus having global implications for patients .', 'The study aimed to evaluate the efficacy of on-demand therapy using 20-mg vonoprazan for mild reflux esophagitis (RE).', 'Thirty patients (28 female, ages: 18-62) with JHS and symptoms of reflux (n=28)\xa0±\xa0dysphagia (n=25), underwent high-resolution manometry and 24\xa0hour pH-impedance monitoring after questionnaire-based symptom assessment.', 'Gastric pH ≤6.', 'Endoscopic plication using the GERDx device may be effective in improving quality of life and GERD symptoms.', 'Reflux-induced asthma remains a vexing problem in the absence of either medical therapy or proven efficacy of a reliable mechanism of prospectively identifying affected patients .', 'Thus the problem with reflux is that gastric juice appears in the oesophagus , an area without any natural protection from proteolytic damage .', 'Gastroesophageal reflux disease has become a serious problem not only for general practitioners but for other specialists as well .']


Cluster  923
['This is done by establishing a 100-word window around a target word -LRB- 50 words on each side -RRB- , and correlating each synset to which the target word belongs with each word in the surrounding window . a given term may be assigned to an implausibly large number of categories', 'This situation , in which semantic analyses and lexicographic descriptions of adjectives -LRB- and other categories -RRB- are rare , is bound to change rapidly . it completely ignores the labeled source data after initialization , but the source data does contain some valuable information', 'Semantic Role Labeling -LRB- SRL -RRB- is the process of assigning semantic roles to strings of words in a sentence according to their relationship to the semantic predicates expressed in the sentence . the scarcity of manually aligned training data', 'The gain of iteration 1 shows that incorporating the target domain data -LRB- unlabeled -RRB- is helpful . the noun modifier relationship is not limited to meronymy', 'PropBank has been used as the training data in recent semantic role labeling competitions as part of the Conferences on Computational Natural Language Learning -LRB- Carreras and M`arquez 2004 , 2005 -RRB- . low representation power', "It is only by modeling the occurrence of repairs and their word correspondences that we can account for the speaker 's words . CLWSD is a lexical sample task , which only evaluates disambiguation of 20 English nouns", 'For many tasks and applications -LRB- e.g. , Web queries -LSB- Jansen , Spink , and Pfaff 2000 -RSB- -RRB- nouns are the most frequently encountered and important part of speech . it attaches to a character rather than to the location between two adjacent characters', 'This situation , in which semantic analyses and lexicographic descriptions of adjectives -LRB- and other categories -RRB- are rare , is bound to change rapidly . it completely ignores the labeled source data after initialization , but the source data does contain some valuable information', 'Semantic Role Labeling -LRB- SRL -RRB- is the process of assigning semantic roles to strings of words in a sentence according to their relationship to the semantic predicates expressed in the sentence . the scarcity of manually aligned training data']


Cluster  735
['Recent industrial developments and increased energy demand have resulted in significantly increased levels of environmental pollutants , which have become a serious global problem .', 'In the USA , MTBE pollution is regarded as a serious environmental problem .', 'This raises a serious environmental concern .', 'It therefore presents a serious environmental problem in different regions of the country and the world .', 'White or plastic pollution has become a serious concern to the environmentalists for the last few years .', 'This is currently a serious environmental problem .', 'This is a serious problem , both in terms of the ecological environment and human health .', 'The increasing environmental pollution with particular reference to emerging contaminants , toxic heavy elements , and other hazardous agents is a serious concern worldwide .', 'With ever increasing development of Nagore , nonpoint sources of pollution may become a serious problem .', 'Environmental pollution has reached a global echo and represents a serious problem for human health .', 'The unprecedented deterioration rate of the environmental quality due to rapid urbanization and industrialization causes a severe global health concern to both ecosystem and humanity .', "On one hand , the country is developing in the field of science and technology and on the other hand , it is encountering a serious problem called ' Environmental degradation ' .", 'Pollution due to petroleum and gas exploration is a serious problem in Assam .', 'Currently , environmental problems have reached alarming levels , constituting a serious problem for public health .', 'Existence of anthropogenic contaminants ( ACs ) in different environmental matrices is a serious and unresolved concern .', 'Environmental pollution is a serious problem of the modern world that possesses a major threat to public health .']


Cluster  1420
['A total of 118 patients with septic shock were recruited in the study.', 'Septic shock is often associated with acute respiratory distress syndrome , a serious clinical problem exacerbated by improper mechanical ventilation .', 'Sepsis and septic shock are a serious problem , particularly in the geriatric population .', 'Septic complications developed in 23.', 'In this prospective observational pilot study, patients identified as having severe sepsis and septic shock underwent transthoracic echocardiography on day 1 and day 3 of their intensive care unit admission.', 'In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg.', 'The SChE activity level was significantly decreased in patients with septic shock.', 'Being younger, spending more days in hospital and living alone were all associated with non-response at 1-year HRQoL follow-up among ICU patients with septic shock.', 'Sepsis is a serious health problem in the elderly with a high degree of mortality .', 'In a post hoc follow-up registry study, we assessed all the Danish survivors in the Transfusion-Requirements in Septic Shock trial patients, who were mailed the Short Form 36-item Survey (SF-36) 1-year after randomization.', 'We carried out a prospective observational cohort study of 304 consented patients presenting with sepsis to a single UK NHS ED (110\u2009000 adult attendances annually) taking paired PV-LACT and A-LACT.', 'The comparison of sepsis markers between all groups showed that the mean values of PCT and CRP were significantly higher in patients with septic shock.', 'The aim of this study is to determine the agreement between PV-LACT and A-LACT in septic patients attending the ED.', 'CKD-712, a candidate treatment for septic shock, acts by increasing cardiac output.', 'Hypotension is a serious problem in septic patients .', "A reduction in septal e'/s' may indicate diastolic dysfunction in patients with severe sepsis and septic shock who have normal systolic function.", 'This was a single-center retrospective observational study of elderly patients with a hospital discharge diagnosis of severe sepsis or septic shock from First Hospital of Tsinghua University from January 2014 to December 2018.', 'Prospective case series including patients with severe abdominal sepsis/septic shock requiring urgent SCL.']


Cluster  1078
['Intimate partner violence ( IPV ) is a serious social problem that is often hidden , unnoticed or ignored .', 'Intimate partner violence ( IPV ) is a serious , devastating , and prevalent problem .', 'In the United States ( U.S. ) , intimate partner violence ( IPV ) is a serious public health concern , mainly affecting the health and well-being of women .', 'Intimate partner violence is a serious global problem that damages the health and prosperity of individuals , their families , community , and society .', 'Intimate partner violence ( IPV ) is a serious health problem and a leading cause of nonfatal injury in North American females .', 'Intimate partner violence is a serious social problem and public health issue affecting the well-being of the young adults .', 'Intimate partner violence ( IPV ) is a severe health problem associated with significant distress and impairment in women .', "Intimate partner violence is a serious global public health problem particularly in low-and middle-income countries such as Ethiopia where women 's empowerment is limited .", 'Intimate partner violence ( IPV ) is a serious public health problem that disproportionately affects adolescent women seeking family planning services .', 'Intimate partner violence ( IPV ) , commonly accompanied by controlling behavior , is a serious public health concern in sub-Saharan Africa .', 'The Centers for Disease Control and Prevention describes intimate partner violence ( IPV ) as a serious , preventable problem .', 'Intimate partner violence is a preventable public health problem .', 'Intimate partner violence ( IPV ) is a serious public health problem associated with increased risk of developing mental health conditions .', 'Inter-partner violence is a serious public health problem for a minority of the population .', "Intimate partner violence ( IPV ) violates women 's human rights and is a serious public health concern .", 'Female same-sex intimate partner violence ( FSSIPV ) is a serious problem that affects the health and safety of lesbian and bisexual women .', 'Intimate partner violence ( IPV ) is a serious public health problem in the United States with adverse consequences for affected individuals and families .', "Intimate partner violence is a serious and pervasive social problem with deleterious consequences for survivors ' well-being .", 'Intimate partner violence ( IPV ) is a serious public health problem in the United States and a common cause of injury .', 'Intimate partner violence ( IPV ) is a serious public health problem , linked with a number of poor health outcomes .', 'Intimate partner violence is a serious and pervasive problem in U.S. society , with 25 % of women and 7.6 % of men reporting physical abuse by an intimate partner each year .', 'Intimate partner violence ( IPV ) is a serious , pervasive problem ; however , professional literature focused on psychotherapy for women experiencing IPV is limited .', 'Intimate partner violence ( IPV ) is a serious public health problem , affecting every 1 in 4 women in their lifetime .', 'Intimate partner violence ( IPV ) is a serious public health concern for all ; however , women who experience IPV are more likely to sustain injury and report adverse health consequences .', 'Intimate partner violence ( IPV ) is a serious global health problem affecting millions of women worldwide .', 'Intimate partner violence ( IPV ) is a serious public health concern that affects many Latinx couples .', 'Intimate partner violence ( IPV ) is a serious public health problem that has received increased attention in the military .', 'Intimate partner violence constitutes a serious health problem worldwide .', 'Intimate partner violence ( IPV ) victimization is a serious public health problem in the world .', 'Intimate partner violence ( IPV ) is a serious public health problem with known negative physical and mental health outcomes for women exposed .', 'Intimate partner violence is a preventable health problem that affects more than 12 million people in the United States each year .', 'Intimate partner violence ( IPV ) is a serious public health problem that disproportionately affects racial/ethnic minorities in the U.S. This study examines risk factors for IPV perpetration that are salient for racial/ethnic minorities ; specifically , we test if racial/ethnic discrimination among Latino men is associated with IPV perpetration , if poor mental health ( MH ) mediates this link , and whether relationships differ by immigrant status .', 'Intimate partner violence ( IPV ) is a serious , and preventable , public health problem in the United States .', 'Interpersonal violence is a serious public health problem in the United States .', "Intimate Partner Violence ( IPV ) is a serious violation of women 's human rights and a dominant chronic global public health problem .", 'Intimate partner violence ( IPV ) is a serious and widespread problem .', 'Studies show high use of alcohol among American women who are victims of intimate partner violence (IPV), but not in Spanish victims']


Cluster  1603
['If found to be beneficial , honey could provide a simple , elegant and cost-effective solution to a troublesome health problem , thus benefiting a large number of patients .', 'The ongoing decline of honey bee health worldwide is a serious economic and ecological concern .', 'Honey contributes to treating VVC.', 'The honeybee disease American foulbrood ( AFB ) is a serious problem since its causative agent ( Paenibacillus larvae ) has become increasingly resistant to conventional antibiotics .', 'The honey bee disease American foulbrood ( AFB ) is a serious problem since its causative agent ( Paenibacillus larvae ) has become increasingly resistant to conventional antibiotics .', 'Due to the high impact of honey bees on ecology and economy this epizootic is a severe and pressing problem .']


Cluster  130
['Foodborne disease caused by Vibrio parahaemolyticus is a serious public health problem in many countries .', 'Giardia and Cryptosporidium species are a serious problem if present in water supplies .', 'Thus , we can conclude that intestinal protozoan infections are still representing a serious public health problem in aboriginal communities , especially among children .', 'Aeromonas species are increasingly recognized as enteric pathogens ; they possess several virulence factors associated with human disease , and represent a serious public health concern .', 'Transmission of pathogenic protozoa and helminths by water is a serious public health problem .', 'Pandemic V. parahaemolyticus isolates have become a serious public health concern .', 'In recent years an increasing incidence of Aeromonas-related cutaneous infections and gastroenteritis has raised a serious public health problem .', 'Protozoan infections are a serious global health problem .', 'Foodborne disease caused by pathogenic Vibrio parahaemolyticus has become a serious public health problem in many countries .']


Cluster  672
['Adults diagnosed with major depressive disorder (N\xa0=\xa048) were randomly assigned to 14 sessions of cognitive therapy-as-usual (CT-as-usual) or cognitive therapy plus the Memory Support Intervention (CT\xa0+\xa0Memory Support).', 'Preventing major depressive disorder relapse/recurrence may depend upon developing DC in addition to managing residual symptoms.', 'The mean score on the depressive cognition scale (DCS) was 20, indicating a high need of PTT to all enrolled CGs.', 'The coexistence of depressive symptoms and cognitive impairment is a serious problem , as it increases adverse outcomes for health , functional status , and mortality .', 'Major depressive disorder ( MDD ) is a serious U.S. public health problem for children and adolescents .', "Treatment-resistant depression is a serious problem with significant costs in terms of health care dollars and patients ' well-being .", 'Refractory major depressive disorder ( MDD ) is a serious problem leading to a heavy economic burden .', 'Major depressive disorder ( MDD ) is a serious US public health problem for children and adolescents .', 'Major depressive disorder ( MDD ) is a serious mental health problem in modern society , which is difficult to identify and diagnose in the early stages .', 'Major depressive disorder ( MDD ) is a serious health concern worldwide .', 'It is not known , however , if it is effective in individuals with partially remitted depressive disorder , which is a serious clinical problem in up to 50 - 60 % of treated patients .', 'Major depressive disorder ( MDD ) is a serious public problem , affecting 4 - 6 % of adolescents at any one time .', 'Our findings suggest that depressive symptoms are associated with future ADL dependence and that living circumstances (except for institutionalization) and marital status do not affect the association.']


Cluster  538
['This may not present a serious problem in clinical settings where extensive interviews determine the need for clinical management .', 'The majority of patients hospitalized with ADHF did not recall discussing their preferences for EOL care with their physician.', 'None of the remaining 167 patients have a serious problem at PSP interrogation ; six had minor issues at PSP check , none of which required repeat surgical intervention .', 'Although specificity was not a serious problem with any of the tests , the SAT was relatively nonsensitive .', 'Patients and physicians were aware of medication, and there was no direct comparison with the herein presented switch of medication.', 'Forgetfulness was not considered to be a serious problem in terms of perceived hindrance and worry by most subjects , independent of their age .', "All thought that something so small and painless could n't be a serious problem .", 'The 83 reports did not provide evidence for AARD being a serious , persistent , contemporary concern in the populations studied , nor did they identify strong interest in adenovirus vaccines .', 'Men in general did not recognize DVAW as a serious social problem ; noticeably , they saw it as a personal and family issue .', 'Anaesthetists tend not to view awareness as a serious problem .', 'The presence of a serious medical problem did not statistically significantly change the rates of completed immunizations .']


Cluster  88
['Crucially , the nested property of projective structures allows edge expectations to be computed in O -LRB- n3 -RRB- from the inside-outside values . an explosion of syntactic parses in natural language systems', 'This demonstrates the advantage of utilizing existing syntactic parsers that are learned from large open domain treebanks instead of relying just on the training data . being sensitive to portions of the graph that are far from the start node because it considers paths of length up to oc', 'A drawback is that this structure may be cubic in the length of the parsed sentence , and more generally polynomial for some proposed algorithms', 'A deep syntax language model comes with the obvious disadvantage that any data it is trained on must be in-coverage of the parser', 'For the case of a pure bottom-up parser , our proof does not rely on the details of unification -- it works for any pattern-matching technique that satisfies certain simple conditions . no idiom or multi-word expression is allowed to align to a single word on the other side', 'The parsing accuracy for parsing word lattices was not directly evaluated as we did not have annotated parse trees for comparison . even by the end of the book , neither Prolog nor parsing has been covered in depth', 'However , one shortcoming of existing parsers is that as the complexity of the sentences recognized increases , the computational complexity increases quadratically', 'This demonstrates the advantage of utilizing existing syntactic parsers that are learned from large open domain treebanks instead of relying just on the training data . being sensitive to portions of the graph that are far from the start node because it considers paths of length up to oc', 'The last few decades have seen tremendous advances in NLP and the emergence of many resources that could be useful for plot unit analysis . it requires high accuracy parsing , at least for constituents composed of temporal expressions', 'Moreover , when the dependency parser is non-projective , our method can perform discontinuous constituent parsing in a very natural way . requiring a great human effort before actually being able to use it', 'A possible problem with this method is in the approximation of exponentially many parse trees by a polynomial-size sample', 'Ontological promiscuity makes it possible to explore more complicated analyses in this general framework . it increases the size of the synchronous context-free grammar massively', 'The parsing accuracy for parsing word lattices was not directly evaluated as we did not have annotated parse trees for comparison . even by the end of the book , neither Prolog nor parsing has been covered in depth', 'The main weakness of this method is that an SF error can be corrected only if the right SF appears at least in one of the n-best parse trees', 'We have also evaluated our sampled SHRG on a string-to-AMR graph parsing task and achieved some reasonable result without using a dependency parse . the representativeness of the N-best list is often a question mark', 'Unsupervised constituency parsing is also an active research area . each request involves the overhead of starting a new Prolog process , and a consequently inflated response time , as well as complex arrangements to maintain dialogue state information', 'In addition to a strictly projective arc-eager parser , we also include a version that uses pseudo-projective parsing -LRB- Nivre and Nilsson 2005 -RRB- to recover non-projective arcs . KB sparsity', 'This demonstrates the advantage of utilizing existing syntactic parsers that are learned from large open domain treebanks instead of relying just on the training data . being sensitive to portions of the graph that are far from the start node because it considers paths of length up to oc', 'Crucially , the nested property of projective structures allows edge expectations to be computed in O -LRB- n3 -RRB- from the inside-outside values . an explosion of syntactic parses in natural language systems', 'In addition to a strictly projective arc-eager parser , we also include a version that uses pseudo-projective parsing -LRB- Nivre and Nilsson 2005 -RRB- to recover non-projective arcs . KB sparsity', 'This volume contains a description of the CoNLL-2012 Shared Task and the participating systems . the relatively low upper bound for the CCG parser on DepBank', 'A drawback of our method is that it increases the size of the synchronous context-free grammar massively', 'In general , the formalism must be able to deal with , discontinuous constituents , a problem not dissimilar to the problems of discontinuous constituents in natural language parsing', 'On the other hand the relatively low upper bound for the CCG parser on DepBank', "And the shell contains a system for evaluating parses , extending IIeidorn 's ( 1982 ) parse metric , which is used not only for ranking final parses but also for pruning away unlikely partial analyses during parsing , thus reducing the problem of parse space explosion"]


Cluster  323
['Fracture of the implant abutment screw can be a serious problem , as the fragment remaining inside the implant may prevent the implant from functioning efficiently as an anchor .', 'Atlantis titanium and titanium nitride abutments showed optimal clinical performances after 3 years.', 'Stripping of the implant abutment screw head can be a serious problem which can render an implant unusable .', 'Instrument separation is a serious concern in endodontics .', 'Abutment screw loosening is a serious problem that can result in abutment screw fractures .', 'The fracture of nickel-titanium rotary instruments is a serious problem that can jeopardise the outcome of root canal treatment .', 'Mechanically assisted crevice corrosion ( MACC ) has been associated with implant failure in vivo and is a serious concern in numerous metallic implant systems .', 'The problem with this limited mode of instruction is that dental students often fail to understand the various chairside procedures required to fabricate a complete denture .', 'A significant problem with most field dental units is that their suction is too weak to effectively remove debris from the mouth .']


Cluster  1315
['Anemia is a severe global public health problem with serious consequences for both the human and socio-economic health .', 'Generally , the study showed that anemia was a severe public health problem among infants and young children in the study setting .', "Anemia is a severe public health problem in the Lao People 's Democratic Republic ( PDR ) .", 'Anaemia was found to be a severe public health problem ( defined as > 40 % anaemic ) in five African countries for children aged 7 - 11 years and in four of the same countries for children aged 12 - 14 years .', 'The prevalence of anaemia is a severe nutritional problem of public health significance .', 'Such findings are consistent with findings of other recent studies in poor , northwest areas of China and led to conclude that anaemia remains a serious health problem among children in parts of China .', 'Anaemia is considered a serious public health problem in Egypt , although updated population-based data are lacking .', 'Anemia among hospitalized children in this study was found to be a severe public health problem .', 'In the rural areas in southern Shaanxi Province , anemia in infants aged 6 - 12 months is still a serious public health problem .', 'Anemia however is a serious public health problem affecting some 30 % of the subjects , with almost half due to ID .', 'The results indicate that anemia is a serious public health problem in Jamaica .', 'Anemia is considered a severe public health problem by World Health Organization when anemia prevalence is equal to or greater than 40 % in the population .', 'Anemia was found to be a severe public health problem in the study area .', 'Microcytic anaemia is getting to be a severe public health concern while malarial anaemia is a mild public health issue in children residing in urban areas of Mount Cameroon .', 'Anemia is a serious public health problem in Indian school children .', 'Infantile anaemia has been a severe public health problem in China for decades .', 'Anaemia is associated with poor health outcomes and is considered a serious public health problem particularly in low- and middle-income countries .', 'Anemia in children and women is a severe public health problem in Sierra Leone .', 'This study has revealed that the prevalence of anemia in children less than five years is high and a severe public health problem in the study area .', 'Anemia among Haitian young children and women of childbearing age is a severe public health problem .', 'Anaemia is a severe public health problem among SAC and adolescents in rural Ghana irrespective of sex .', 'Anemia is a serious concern among indigenous populations in North America , and it appears to be widespread among the Inuit despite abundant intakes of heme iron .', 'Anaemia is a severe public health problem amongst all vulnerable age groups in India .', 'Anaemia is a serious health problem in the contemporary world which aff ects 24.8 % of the total human population .', 'Anaemia is considered a severe public health problem by WHO and is seen as such in Ghana .', 'Anaemia is known to have an impact on child development and mortality and is a severe public health problem in most countries in sub-Saharan Africa .', 'Childhood anaemia is considered a severe public health problem in most countries of sub-Saharan Africa .', 'Anemia in children living at all three altitude categories is more than 40 % and a severe public health problem according to the World Health Organization .']


Cluster  193
['The disease represents a serious animal health concern in many rural areas of the world , causing important economic losses derived from decreased productivity and viscera condemnation in livestock species .', 'A severe reoccurrence of AR was found in 2 of the 10 AR problem farms .', 'PCVAD may be only a sporadic individual animal diagnosis ; however , PCVAD may also manifest as a severe herd problem accelerated and enhanced by concurrent virus or bacterial infections .', 'Dictyocaulus infection of goats does not appear to be a serious problem .', 'Livestock constitute habitual hosts and carriers for several infectious pathogens which may represent a serious public health concern affecting the readiness of military forces and lead to wide economic losses .', 'Claw lesions are a serious problem on dairy farms , affecting both the health and welfare of the cow .', 'TBF is widespread along the coast of southern Norway and may cause a severe problem for the sheep industry .', 'Cattle with hygromas are a potential source of infection to other animals and a serious public health problem .', 'It is now apparent that deer are highly susceptible to both forms of the disease , the sheep-associated form being a serious problem in farmed deer .', 'Piroplasmosis in donkeys has been recognized as a serious problem of major economic importance , since the affected animals manifest loss of appetite and decreased working capacity .', 'Resistance is also a serious concern in the intensive goat industry , but at present appears to occur only on isolated , individual cattle properties .', 'Malignant catarrhal fever ( MCF ) is a fatal lymphoproliferative disease that represents a serious problem in the deer-rearing industry .', 'Equine piroplasmosis represents a serious problem in horse industry .', 'This is a serious problem particularly for sheep and goats in the southern hemisphere .', 'These findings strongly suggest that AR , particularly in Haemonchus sp. , is a serious problem in these sheep flocks .', 'The results suggest that a considerable number of wildlife ruminants are asymptomatic carriers that may serve as reservoirs of the infection posing a serious concern in terms of piroplasmosis control .', "Infection with Mycobacterium avium subsp . paratuberculosis causes Johne 's disease in cattle and is a serious problem for the dairy industry worldwide .", 'This study supports the suspicion that paratuberculosis may constitute a serious problem in Morocco , particularly in sheep flocks involved in cross-breeding programmes .', 'Infectious Bovine Keratoconjunctivitis ( IBK ) is one of diseases of a very complex etiology constituting a serious epizootiologic and economic problem in cattle raising on a large scale .', 'This disease represents a serious problem for the horse industry and its control is critical for the international trade of horses .']


Cluster  1387
['Using a controlled trial, this study aimed to evaluate the effectiveness of adhesive strapping to improve the natural healing rate of umbilical hernia.', 'Erosion of a laparoscopic adjustable gastric band ( LAGB ) is a devastating problem .', 'The need for stapling is a relative drawback of laparoscopic hernia repairs because it adds to the complications and costs .', 'Labral repair with either knot-tying or knotless suture anchor resulted in significant postoperative improvements and no difference between the two groups after 2\xa0years of follow-up.', 'Some 370 patients who underwent Lichtenstein hernia repair were randomized to receive either glue (Histoacryl®) or non-absorbable polypropylene sutures for fixation of lightweight polypropylene mesh.', 'Among them are the issue of safety of the intraperitoneal mesh placement , traditionally considered a major drawback of the laparoscopic technique , the role for the biologic meshes , and various aspects of the laparoscopic approach for particular locations of the defect such as the abdominal border or parastomal hernias .', 'In particular , the differentiation between the normal and pathological adherence of the labrum is a serious clinical problem .', 'Insertion of all 16 diabolo-shaped mesh constructs during laparotomy was uneventful.', 'Knot slippage continues to be a serious concern in surgery .']


Cluster  579
['To compare the efficacy of video capsule endoscopy (VCE) with computed tomography enterography (CTE) in potential small bowel (SB) bleeding, and to identify factors predictive of a high diagnostic yield for CTE.', 'The EGD-colonoscopy sequence may be considered the preferred sequence for same-day bidirectional endoscopy as a result of less cardiovascular stress, lessened need for sedation with propofol, and faster recovery.', 'To determine whether providing clinic correspondence and endoscopy reports to patients leads to improved understanding, satisfaction or anxiety.', 'A randomized, endoscopist-blinded, multicentre study.', 'A total of 209 eligible outpatients scheduled for diagnostic same-day bidirectional endoscopy between 16 February 2016 and 30 April 2016 were randomly assigned to the EGD-colonoscopy (n = 106) and colonoscopy-EGD (n = 103) sequence groups.', 'A total of 603\u2009807 endoscopic procedures among 451\u2009470 individual patients were used in the workup of GIB, with 152\u2009337 procedures among 113\u2009030 patients (25%) being performed as a secondary procedure.', 'Magnetically controlled capsule endoscopy (MCE) is a novel technique for which there is no agreed gastric preparation.', 'The aim of this study was to compare the accuracy of magnifying endoscopy with narrow band imaging for the diagnosis of depth of invasion by Japan Esophageal Society (JES) classification and inter- and intraobserver agreement of JES intrapapillary capillary loop (IPCL) classification.', 'Buried BE may be a serious clinical problem since it can go unnoticed during surveillance endoscopies .', 'ADRs increased at the sites participating in the endoscopic quality improvement program.', 'High-volume FMT via endoscopic jejunal route is an effective treatment option that is well tolerated and easy to perform.', 'Incidental findings of high-grade dysplasia or gastric cancer at random biopsies with endoscopic diagnosis of chronic gastritis constitute a serious problem to clinical management of patients and sometimes requires blind gastrectomy .', 'The majority of patients with GIB require only one type of endoscopy to manage their bleeding.', 'Endoscopy is performed with air insufflation and is usually associated with abdominal pain.', '- This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative.', 'Endoscopic mucosal resection (EMR) is widely used for treating gastrointestinal polypoid lesions.', 'The electronic database was queried for all patients aged 18 years and older who underwent an endoscopic evaluation for any bleeding indication between 2000 and 2014.', 'A prospective, randomized, controlled trial was conducted in a single academic endoscopy unit.', 'Endoscopists who do not allot adequate examination time may overlook neoplastic lesions in the upper gastrointestinal tract.']


Cluster  995
['A critical drawback of the black-blood technique , however , has been its single-slice nature , as there is only one point in time during the recovery of the blood magnetization from inversion at which the signal is completely nulled .', 'To solve such a serious problem , a dual magnetoimmunosensor is proposed for simultaneous assessment of two of the most important sepsis biomarkers : procalcitonin ( PCT for early phase ) and C-reactive protein ( CRP for late phase ) .', 'Environmental magnetic flux density (MFD) was measured in and around incubators.', 'Although superparamagnetic iron oxide ( SPIO ) nanoparticles have been developed as a contrast agent for magnetic resonance imaging ( MRI ) , acute iron overload due to the persistently high retention of SPIOs in the liver and spleen that are slowly converted to ferroproteins is a serious safety concern .', 'A major drawback of EPI is the substantial geometric distortion and signal loss that can occur due to magnetic field inhomogeneities close to air-tissue boundaries .', 'Inhomogeneities of the static magnetic field and the different susceptibilities of the various types of tissue are a serious problem for all imaging methods of spectral separation of fat and water .']


Cluster  2319
['Coronavirus disease 2019 ( COVID-19 ) is a serious health concern which affects all healthcare professionals worldwide .', 'The outbreak of COVID-19 has created a serious public health concern worldwide .', 'However , due to the worldwide spread of the virus , COVID-19 has become a serious concern in the medical community .', 'The results of this review indicated that COVID-19 is a serious global public health problem .', 'The Coronavirus Disease 2019 ( COVID-19 ) pandemic remains a serious public health problem and will continue to be until effective drugs and/or vaccines are available .', 'The coronavirus disease 2019 ( COVID-19 ) has become a serious problem for public health since it was identified in the province of Wuhan ( China ) and spread around the world producing high mortality rates and economic losses .', 'The COVID-19 outbreak has become a serious public health problem worldwide .', 'A severe outbreak of coronavirus disease 2019 ( COVID-19 ) emerged in China in December 2019 , and spread so rapidly that more than 200,000 cases have so far been reported worldwide ; on January 30 , 2020 , the WHO declared it the sixth public health emergency of international concern .', 'Such current findings impede researchers from recommending an appropriate and effective antiviral therapy against COVID-19 , making it a serious concern for the global community .', 'Coronavirus disease 2019 (COVID-19), a novel pneumonia disease originating in Wuhan, was confirmed by the World Health Organization on January 12, 2020 before becoming an outbreak in all countries', 'The novel COVID-19 infection is a severe public health problem which is causing an increasing number of deaths worldwide .', 'COVID-19 is a severe health problem in many countries and has altered day-to-day life in the whole world .', 'The Covid-19 is a highly contagious disease which becomes a serious global health concern .', 'The spread of coronavirus 2019 ( COVID-19 ) is a serious problem all over the world .', 'Because of the human-to-human transmission and rapid spread ; coronavirus disease 2019 ( COVID-19 ) has rapidly increased to an epidemic scale and poses a severe threat to human health ; it has been declared a public health emergency of international concern ( PHEIC ) by the World Health Organization ( WHO ) .', 'Coronavirus disease 2019 ( COVID-19 ) has become a serious public health problem worldwide .']


Cluster  1137
['We reviewed 190 patients who underwent ESD before and after we switched the acid secretion inhibitor from rabeprazole to vonoprazan.', 'Adverse cutaneous drug reactions associated with antiepileptic drugs ( AEDs ) are a serious problem in the clinical setting .', 'Scarring rates were not different between vonoprazan and rabeprazole (31.', 'Corticosteriods have been shown to impair wound healing , which has become a serious clinical problem in wound care .', 'Vonoprazan was superior to rabeprazole for healing ESD-induced ulcers.']


Cluster  557
['Traumatic pericarditis ( TP ) remains a serious problem facing bovine producers ; particularly in the developing countries ; causing severe economic losses .', 'This study demonstrates that lung diseases and lesions represent a serious problem and may continue to be a drawback to livestock industry and may pose health risks to meat consumers from contrasting zoonotic diseases in western Iran .', 'Dehydration is a serious welfare concern in horses working in developing countries .', 'Respiratory disease is a serious and significant health problem for the bovine industry .', 'The overall impression is that farmers do not regard heartwater in cattle as such a serious problem as it is generally believed to be.(ABSTRACT TRUNCATED AT 250 WORDS )', 'Bovine respiratory disease ( BRD ) continues to be a serious health problem in beef cattle production .']


Cluster  1172
['Stent thrombosis ( ST ) remains a catastrophic problem in patients undergoing percutaneous coronary intervention ( PCI ) .', 'To report the outcomes of WUS patients with large vessel occlusions, selected for intervention based on Alberta Stroke Program Early CT Score (ASPECTS) and treated with stent retrievers or primary aspiration thrombectomy.', 'Bare metal or drug-eluting stent implantation in last remaining vessel PCI ? A serious dilemma .', 'Deferred stenting (≥7 days) in patients with a high thrombus burden was safe on a background of GPI therapy.', 'From April 2015 to February 2017, we enrolled consecutive patients undergoing scheduled carotid artery stenting in our institution.', 'Patients undergoing coronary interventions are in jeopardy of periinterventional thrombotic complications , and stent thrombosis , although a rare event , is still a serious problem , especially in the era of drug-eluting stents .', 'Data were collected retrospectively for each consecutive WUS patient undergoing mechanical thrombectomy with a stent retriever or primary aspiration catheter between February 2015 and September 2016.', 'Single-center, retrospective, observational study involving patients who underwent percutaneous coronary intervention (PCI) with at least one stent implanted for the LMD.', 'Late adverse events including late stent thrombosis and late catch-up phenomenon after percutaneous coronary intervention have been a serious clinical problem in the drug-eluting stent era .']


Cluster  2256
['Drowning is the third leading cause of death for children aged 0 - 4 years in many Asian countries , and is a serious but neglected health problem in low and middle-income countries like Bangladesh .', 'Drowning is a serious worldwide , mostly preventable injury problem , particularly among international travelers .', '[ Death by drowning , a serious population-political problem ] .', 'Childhood drowning remains a serious public health problem worldwide .', 'Drowning is a serious but neglected health problem in low-and middle-income countries .', 'Accidental drowning of children under five is a serious problem in China .', 'Drowning , which typically involves a watery environment , remains a serious public health concern claiming an estimated 362 000 lives per year worldwide across all socioeconomic classifications and has remained under close observation by the World Health Organization and its signatories .']


Cluster  205
['Patients admitted to Australian intensive care units are often critically unwell, and present the challenge of increasing mortality due to an ageing population', 'A Receiver Operating Characteristic (ROC) curve analysis was conducted in a prospective, observation study with inpatients ranked by nurse practitioners (NP) into levels of respiratory distress.', 'A prospective descriptive study was performed in the ICU of a training hospital.', 'The study was conducted as a single-center, non-randomized, controlled, before-and-after study at an 18-bed intensive care unit (ICU) of a university hospital.', 'This was an observational study performed at a university Level 1 trauma center intensive care unit.', 'A total of 144 patients with an expected length of stay in the ICU of at least 72 hours and with an admission glucose or two random glucose values of >10.', 'The main exposure was time spent in different MAP categories during the first 24\u2009h after ICU admission.', 'This retrospective observational study was conducted between July 1<sup>st</sup>, 2017 and February 28<sup>th</sup>, 2018 in a 19-bed EICU.', 'This was a retrospective observational study conducted at Glasgow Royal Infirmary ICU between January 2010 and December 2013.', 'A total of 18,065 ICU survivors participated in this study.', 'Patients with CKD and ESRD have increased in-hospital mortality and periprocedural adverse events with longer hospital length of stay, when compared with those without CKD.', 'This retrospective observational study was based on the Medical Information Mart for Intensive Care III (MIMIC III), a large critical care database.', 'We performed a prospective, observational study of all ICU deaths in Sweden from Jan 1, 2009 to Dec 31, 2014.', 'Using a Japanese health insurance claim database, we identified adult patients receiving CRRT in intensive care units (ICUs) from April 2014 to October 2015.', 'On average, 134 (internal ICU) and 182 (surgical ICU) HHOs per patient were observed during the 12h observation period.', 'A clinical observational study of 16 critically ill patients in a nine-bed mixed university hospital ICU.', 'Monitored NSVT bouts in ICD recordings may serve as a predictor of future HF hospitalizations in ICD recipients with HF suggesting optimization of therapeutic modalities in these patients along with a close supervision in the clinical setting.', 'The present study revealed associations of various cardiovascular medications at ICU discharge with decreases in 1-year overall mortality among ICU survivors.', 'Patients admitted in Intensive Care Unit were randomized to standard or to NIR assisted procedure.', 'CRRT without anticoagulation with saline flushes is a viable, safe and effective strategy in critically ill patients with high risk of bleeding.']


Cluster  879
['Foodborne viruses have been recognized as a growing concern to the food industry and a serious public health problem .', 'Frequently cited statistics indicate that the burden of foodborne disease is a serious public health problem , particularly for vulnerable populations such as children .', 'Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $ 50 billion annually .', 'Food contamination due to the presence of microorganisms is a serious problem .', 'Foodborne illness is a serious public health concern .', 'Food borne diseases are a serious public health problem .', 'Foodborne illnesses caused by bacterial microorganisms are common worldwide and constitute a serious public health concern .', 'Food contamination continues to be a serious problem around the world .', 'Bacterial contamination continues to be a serious concern for food safety .', 'Food corruption and spoilage caused by food-borne pathogens and microorganisms is a serious problem .', 'Ever since this accident , Cs-137 in foods has become a serious problem .', 'Foodborne illness resulting from infectious organisms occurring in vegetables and processed meat is a serious health concern in the United States .', 'Foodborne illness is a serious and preventable public health problem , with high health and economic tolls in the United States .', 'Food spoilage represents a severe problem for food manufacturers .', 'In recent years , food safety incidents become a serious social problem .']


Cluster  141
['Hematoporphyrin-PDT combined with stent placement is an effective and safe treatment for EHCC.', 'LMWH with TACE in HCC is strongly recommended for prevention of thromboembolism complications (PVT).', 'In terms of technical feasibility, LACH represents a safe alternative for abdominal HE when LAVH is contraindicated.', 'There was no difference on CRBSI-free or dysfunction-free survival between jugular vein CVC locked with heparin or 30\xa0% citrate.', 'A total of 52 patients with HCC, who underwent B-TACE using MPT in addition to the balloon-occluded CBCT hepatic arteriography, were studied.', 'This study was carried out on 40 patients with HCC requiring TACE who presented to the Tropical Medicine Department of Tanta University and Interventional Radiology Department of Ain-Shams University Hospitals.', 'This study was carried out on 40 patients with HCC requiring TACE who presented to the Tropical Medicine Department, Tanta University and Interventional Radiology Department of Ain-Shams University Hospitals starting from April 2015.', 'Citrate 4% lock solution is equally effective as heparin in maintaining catheter patency in dialysis patients.']


Cluster  565
['We provide occurrence rates of migraine headaches, an under-recognized adverse event, in patients undergoing catheter-based cerebral angiography.', 'The anastomoses of cortical veins may provide compensation for venous transaction.', 'Device- or technique-related air embolism is a drawback of various neuro-endovascular procedures .', 'We performed a prospective study of 42 consecutive surgically treated PSM patients who underwent preoperative evaluation of peritumoral cortical veins using a 3D venous-tumor fusion model established by a neuronavigation system.', 'Pulmonary embolism is a serious problem in patients with lesions of the central nervous system , with a mortality rate estimated at 15 % or higher .', 'Risk in balloon angioplasty of arteries irrigating the brain is a serious problem .', 'The thalamic pain syndrome , a rare sequelae of cerebrovascular event , is a severe and disabling form of central pain which treatment remains a major clinical problem .', 'Consecutive patients who underwent cerebral angiography through the transfemoral (or infrequently radial) route were included.']


Cluster  682
['Dehydration is frequently associated with fever in infants younger than 8 days of age seen in a PED.', 'This observational, multicenter study included children aged 6 months to 3 years who were either febrile (fever ≥12 hours, ≥ 39°C and ≥38°C at inclusion) or non-febrile and well.', 'The 8 parameters suggested that SB and fever are two independent manifestations that are activated simultaneously during an infection.', 'Fever of Unknown Origin ( FUO ) is a vexing clinical problem .', 'Trying to differentiate serious bacterial infection (SBI) from a self-limiting illness in febrile infants seen in the pediatric emergency department (PED) is a significant challenge.', 'Of the 895 children under 8 days of age who visited the PED, 69 consulted for fever.', '200 febrile children (most with nonspecific upper respiratory infections) and 200 non-febrile children were included.', 'Undiagnosed fever is a vexing problem .', 'We found 220 febrile episodes in 146 patients.', 'The definition of fever is flexible and depends on the clinical context']


Cluster  743
["Our results suggest that the common strategy of using ' marquee ' large users to kick-start a platform technology has an important drawback of potentially creating information silos .", 'A problem with the " encouragement " is that it frequently runs amuck of antitrust regulations .', 'The problem with applying the concept of Strategic Quality Management ( SQM ) using Hoshin Kanri , is that it can tend to challenge the traditional authoritarian strategic planning models , which have become the paradigms of modern business .', 'The problem with these responses is that they fail to adequately consider the role that gene patents and patents on similar biomolecules play in facilitating investment in the costly and risky developmental processes required to transform the underlying inventions into marketable products .', 'Tame runaway cost creep . Eroding margins are a serious problem .', 'P2P lenders suffer a severe problem of information asymmetry , because they are at a disadvantage facing the borrower .', "In 1937, Ronald Coase published 'The Nature of the Firm' [1], addressing the question of why firms exist", 'The result is a nascent market in which a patent thicket is in theory a serious risk . Whether it will prove a problem in practice depends in large part on how efficient the licensing market turns out to be .', 'Many unintended consequences of financial incentives noted were either only concerns or attributable to ancillary quality-improvement initiatives.', "If `` stake '' can be interpreted to mean something as vague as ` Stake as any kind of investment in any enterprise ' then the answer is yes . the criterion for selecting patterns , precision , is not the only issue for a pattern to be effective", 'We use the relative price method to measure market fragmentation and find that market fragmentation is indeed a serious problem in China .', 'The major problem with the strategic plans of most AMCs is that they are based on conventional industry wisdom .']


Cluster  1144
['The aim of this protocol is to investigate discriminating tongue features to distinguish between CKD and normal people, and establish differentiating index to facilitate the noninvasive detection of CKD.', 'The DHSS is a valid and reliable swallow screening tool with moderate agreement, high specificity, and reliable predictive values when compared with the MASA.', 'Eight patients (50%) with CPEO and single LSDs of mtDNA had a prolonged cold-water test, including one with a PEG-tube, who was unable to perform the test, and nine patients reported subjective swallowing problems (56.', 'Sniff test is a common method before unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) to select a nostril insertion site.', 'We measured serum total T and free T in saliva using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 30 infant boys, aged 1-6 months, and in 12 adolescents, aged 11-17 years.', 'The results of this study will systematically evaluate tongue manifestations of patients and examine its efficacy as an early detection and diagnosis of CKD.', 'An overnight incubation is a significant drawback of highly sensitive bDNA assays .', 'Tests were performed using fresh saliva collected by synthetic swap early morning after overnight fast (standard).']


Cluster  645
['This prospective observational study was conducted at 4 emergency departments.', 'A prospective longitudinal study was undertaken in our hospital during the period December 2010-December 2014.', 'An observational, prospective, monocentric, and noninterventional study was conducted in the University Hospital of Toulouse in 2015 during a 5-week period.', 'In this retrospective, observational study, we assessed all patients managed in the emergency department (ED) during a 6-month period, with 30\xa0days of follow-up.', 'This study was conducted in one emergency department in Northern Italy.', 'This retrospective observational study was conducted at a single tertiary academic hospital.', 'Our study aimed to assess the long-term efficacy of intensive case management in frequent users of the ED.', 'We conducted an observational and prospective study in a French university hospital.', 'A randomized, double-blind, placebo-controlled trial was performed in the ED of a single high-volume teaching hospital.', 'This observational study was conducted in a 781-bed tertiary hospital from July 2016 to March 2017.', 'We conducted a retrospective observational cohort study, in 34 French CAH centers.', 'This was a prospective, observational study conducted in the emergency department (ED) of a tertiary care medical center.', 'Retrospective observational case study and case series in the hospital setting.', 'We performed a single center, retrospective observational study on patients who presented to the emergency department in a Japanese tertiary care center from January 1, 2010 to March 31, 2016.', 'A randomised controlled study was conducted among French speaking general practice residents.', 'We performed a prospective observational study at a tertiary care ED with 130,000 visits annually.']


Cluster  1211
['In the PROMOTE study, 400 pregnant patients were randomly assigned to 1 of 3 study groups: usual care plus OMT (OMT), usual care plus placebo ultrasound treatment (PUT), or usual care only (UCO).', 'The results support that it is feasible to retrieve a uterus safely from a live donor.', 'A randomized controlled equivalence trial implemented at eight hospitals and health centers in Central Uganda will include 1192 eligible women with incomplete abortion of uterine size >\u200912\u2009weeks up to 18\u2009weeks.', 'In the present times when newer delivery systems of contraceptive agents and menstrual regulation procedures are increasingly used for fertility regulation , it is inevitable that confirmation of early pregnancy poses a severe problem .', 'This study confirms the existence of a serious preventable obstetrical problem .', 'To evaluate the safety of an OMT protocol applied during the third trimester of pregnancy by analyzing incidence of high-risk status and labor and delivery outcomes.', 'The objective of this study was to determine the effectiveness of this approach in a large cohort of women at risk for poor pregnancy outcome due to GALD.', 'Seventy women seeking surgical abortion at 10-14 weeks were allocated to receive one osmotic dilator 16-17\u2009h or 6-7\u2009h prior to an abortion.', 'In this prospective cross-sectional study, AGD measurement was performed in 111 patients with singleton pregnancy from 11 to 13 weeks and 6 days (CRL 45-84\u2009mm).', 'A total of 188 treated pregnancies in 151 women were analyzed.']


Cluster  2262
['However , in a pressure-driven membrane separation process ( i.e. , filtration ) , membrane fouling caused by adhesion of plasma proteins is a severe problem .', 'Membrane biofouling remains a severe problem to be addressed in wastewater treatment systems affecting reactor performance and economy .', 'Silica scaling of membranes used in reverse osmosis desalination processes is a severe problem , especially during the desalination of brackish groundwater due to high silica concentrations .', 'However , fouling of RO membranes has been a severe problem and key limiting factor in the widespread application of the RO process .', 'As the cake resistance of the membrane caused a serious problem , a stainless-steel prefilter and air backwashing methods were applied to minimize the cake resistance effectively .', 'Polysulfone ( PSf ) membrane has been widely used in water separation and purification , although , membrane fouling is still a serious problem limiting its potential .']


Cluster  2148
['A major drawback of filtering is that it often diffuses/blurs important structures along with noise .', 'A major drawback of many filtering techniques is image degradation by diffusing/blurring edges and/or fine structures .', "A common problem with such a filter is that , because it is only a single term out of the circular decomposition , it does not contain much of the reference object 's energy ."]


Cluster  1490
['It is generally accepted that the cellular processing represents a major drawback of current nanoparticle-based therapeutic systems .', 'Polyethylene glycol-modified ( PEGylated ) liposomes have been widely used because of their long circulation time , but they have a major drawback of limited cellular uptake .', 'To develop a novel docetaxel (DOC)-loaded lipid microbubbles ( MBs ) for achieving target therapy and overcoming the poor water-solubility drawback of DOC .', 'Chitosan ( Ch ) nanoparticles have emerged as a promising vector for gene delivery , nonetheless slow dissociation rate of the nanoparticles in cytoplasm is a drawback of using Ch .', 'In order to overcome such a drawback of atRA , we prepared biodegradable microspheres to provide continuous release of atRA for a long period of time .', 'This study confirmed safety and long-lasting efficacy of dorzolamide loaded-nanoliposome eye drop.', 'A major problem with many promising nano-sized biotherapeutics including macromolecules is that owing to their size they are subject to cellular uptake via endocytosis , and become entrapped and then degraded within endolysosomes , which can significantly impair their therapeutic efficacy .', 'Actually , unwanted premature drug leakage before arriving at the acidic tumor site has become a serious problem for polymersomes encapsulating water-soluble drugs , especially when the drug loading is at a high level , thus limiting the therapeutic efficacy .', 'A major drawback of most polymeric vesicles is the lack of biofunctionality , which restricts their ability to interact with cells and tissues .']


Cluster  679
['There are sex differences in the predictors of LV DD in untreated HTN.', 'Both risk models were applicable for Indian patients.', 'Patients with DF were randomly divided into an experimental group and a control group.', 'GD and GO were associated with increased mortality, especially in males.', 'Children of LG halved the risk (HR\u2009=\u20090.', 'One hundred and twenty-nine of the 222 GEDV values were decreased (prevalence of hypovolemia of 58.', 'In the pooled analysis of Phase 3 GFL studies, 55.', 'Seventy-five subjects were randomly allocated to receive either a GFD (n=35) or an HCD (n=40).', 'The hypertension, diabetes and current smoker rates were significantly higher.', 'LVDD might be less prevalent (13%) in pediatric patients compared with adults.', 'In the multivariate analysis, concomitant diabetes mellitus turned out to be an independent predictor of LV DD in women (<i>P</i>=0.', 'In group A, FLV was negatively correlated with Apgar score and the occurrence of RDS.', 'The Dd of patients before PDL treatment was 13.']


Cluster  1266
['The program had a beneficial effect on posttraumatic stress in the short term, but did not affect general stress or parental stress.', 'Significantly higher satisfaction scores were found in both intervention groups as compared with control, but there were no significant changes in EPDS or PSI-SF.', 'Evaluation of the mean scores obtained from the Brief Symptom Inventory before and after the intervention showed a significant decrease in the scores between groups (P < 0.', '(1) After the intervention, the SCL-90 score of the intervention group decrease significantly, and a statistically significant difference is observed with the figure before the intervention (P<0.', 'The results showed a significant difference between both intervention and control groups in terms of self-esteem and happiness (P < 0.', "In the intervention group, patients' knowledge level was significant higher than in the control group, while no differences were found in beliefs.", 'Improvement were observed in both intervention groups in all the included variables at 6 and 12 weeks (p<0.', 'Analysis of original data showed several significant improvements in favor of the intervention group, but also some of the control group.', 'The intervention achieved mixed results.', 'For the intervention group (n = 33), the project interventions were found to be statistically significant t(32) = 6.', 'On the original protocol-specified primary outcome measure - overall improvement rates - there was a significant effect of treatment group.', 'Intervention A had significant results in contrast to intervention B in BBS when referred to equilibrium variables (p\xa0=\xa00.', 'The intervention created some change in self-reported intentions and thoughts but did not create significant behavior change on the campus exposed to it.', 'This clinical trial study assessed the outcome measures within and between groups before and after the intervention.', 'When PMS mean scores of the intervention and control groups during 3 follow-up periods were compared, it was found that there is a statistically significant difference between intervention and control groups (p<0.']


Cluster  2096
['( 1 ) Shingles , especially in the 50 + age group , constitutes a serious health problem in Poland , being a cause of numerous advices in basic health care and at clinics in Poland , as well of numerous hospitalizations and dangerous complications .', 'Asthma is a serious health and social problem , also in Poland .', 'Allergic conditions present a serious problem for the Polish population .', 'Atopic dermatitis is a serious health problem in Poland .']


Cluster  379
['Recently, with the development of ICT, nursing education and learning with ICT have spread.', 'Social media resulted in the largest number of recruits, followed by traditional methods and broadcast email.', 'Resources used by students reflect access to high-yield material and increased Internet use.', 'The use of digital media such as the Internet and Computer games has greatly increased.', 'Health profession educators can adopt Facebook as an education delivery platform to offer personalized, social learning incorporating cultural competency curricula into ongoing education and training in rising awareness on CC.', 'A main concern that remains with the continued growth of online nursing education programs is the way educator and student relationships can be affected by new technologies']


Cluster  1130
['Fluorescence measurements were used to investigate the build up of PpIX within the tumour tissue during the 3h long occlusive treatment prior to irradiation.', 'Extended MAL application with and without curettage increased PpIX accumulation significantly compared with the standard 3hC+ regimen (P = 0·001 and P = 0·002, respectively).', 'The median PpIX level in the +Cur field after 3\u202fh was 22 arbitrary units (AU), which represents the amount of PpIX that could have been photobleached after pulse-PDT with maximal treatment effect.', 'To investigate whether increased PpIX accumulation improves the effect of MAL-PDT for AKs in a randomized intra-individual study.', 'Increased PpIX accumulation does not improve the effect of MAL-PDT for AKs on the hands, but leads to worse adverse events.']


Cluster  828
['Myocardial fibrosis is a severe global health problem due to its prevalence in all forms of cardiac diseases and direct role in causing heart failure .', 'Moreover , despite many breakthroughs in cardiovascular medicine , the complications of a myocardial infarction such as chronic heart failure remains a serious worldwide problem .', 'Heart failure (HF) is a major cause of death in cardiovascular disease.', 'In the last few years , diastolic heart failure has become a serious clinical and epidemiological problem .', 'Chronic heart failure after myocardial infarction is still a serious problem without a fundamental therapy .', 'Despite improved understanding of both disease mechanisms and the quality of care , congestive heart failure ( CHF ) remains a serious clinical problem .', 'Chronic heart failure ( CHF ) , the final phase of various heart diseases , is a serious public health problem resulting in high hospitalization rates , mortality , and increasing health care costs .', 'Chronic heart failure ( CHF ) , not only a severe personal healthy problem but also a social financial burden , has become a global health concern .', 'Heart failure is a serious public health concern that afflicts millions of individuals in the United States .', 'Congestive Heart failure ( CHF ) is a severe pathology representing a major public health problem in industrialized nations which is increasing in prevalence and incidence .', 'Congestive heart failure is a serious health problem in Western society .', 'Heart failure has been identified as a serious international problem , in particular for aging groups , posing both an increasing number of patients on waiting lists in countries susceptible with Medicare systems and increasing financial burdens .', 'Heart failure ( HF ) is a chronic , systemic disorder that presents a serious and growing public health problem due to its high prevalence , mortality , and cost of care .']


Cluster  217
['Patients with facial erythema may be successfully treated with IPL or PDL.', 'A retrospective observational study was conducted to assess 16 patients with facial IH, allocated into 2 groups (n\u200a=\u200a8).', 'Thirty patients with facial seborrheic dermatitis were enrolled and randomly distributed to three groups.', 'A 12-week, prospective, randomized, split-face clinical trial was conducted.', 'Internal browpexy combined with blepharoplasty could be considered the better procedure in patients with upper eyelid dermatochalasis in terms of long-lasting stability and lateral brow elevation.', 'A validation study was conducted in 24 patients with acne using split-face design.', 'To compare the results of internal browpexy (IBP) and temporal brow lift (TBL) in patients with dermatochalasis undergoing simultaneous upper blepharoplasty.', 'Retrospective, observational, case-control study of 242 patients with central face papulopustules.', 'We performed a split-face comparative study in 20 Korean patients.', 'Prospective investigation of a cohort of 15 subjects with unwanted bilateral facial erythema.', 'To evaluate the comparative efficacy of pimecrolimus 1% cream with different regimens for the treatment of facial seborrheic dermatitis.']


Cluster  1946
['One hundred and 34 patients scheduled for total thyroidectomy were included to this prospective randomised controlled clinical study.', "SSKI given before operation in patients with Graves' disease reduces blood loss during thyroidectomy.", 'To unveil the real effect of surgical drains on the outcomes of thyroidectomy for benign thyroid disorders.', 'Autoimmune thyroid disease is a serious medical problem in which various operative procedures are performed .', 'As the incidence of thyroid cancer has increased , hypocalcemia , a common complication of thyroid surgery , has become a serious problem .', 'A total of 90 patients aged 18 to 60 years, American Society of Anesthesiologists (ASA) class I to II, with a body weight of 50 to 90 kg, scheduled for total thyroidectomy were enrolled after ethics committee approval in this prospective, randomized, double-blind, controlled study and divided randomly into 3 groups to receive treatment after hemostasis.', 'This prospective study verified that routine drainage adds no significant advantage in the prevention of post-thyroidectomy bleeding, but it prolongs hospitalization.']


Cluster  104
['Platelet-rich plasma is effective and safe for skin rejuvenation, comparable to readymade growth factors with noticeable higher longevity.', 'Patients were randomized to receive 600\xa0mg of ortho-silicic acid stabilized by hydrolyzed collagen (group 1, n\xa0=\xa011) or placebo (group 2, n\xa0=\xa011) to be taken 15\xa0minutes before breakfast for 90\xa0days.', '"Skin boosting" with injections of hyaluronic acid has been demonstrated to improve aged skin.', 'Skin regeneration is a vexing problem in the field of regenerative medicine .', 'Ortho-silicic acid stabilized by hydrolyzed collagen in a daily dose of 600\xa0mg showed positive results in skin rejuvenation according to clinical evaluation in firmness, hydration, and skin texture.', 'This study aimed to evaluate skin changes associated with the use of ortho-silicic acid stabilized by hydrolyzed collagen.', 'In this study, a comparison between hyaluronic acid (HA, the gold standard for skin rejuvenation), and this novel autologous formulation has been conducted.', 'Compare the efficacy and safety of PRP to readymade growth factors in skin rejuvenation.']


Cluster  121
['Voice with tracheoesophageal speech (TES) is an effective, widely recognized option to restore the ability of oral communication to laryngectomized patients', 'All subject groups showed significant reduction of vocal function (highest pitch production, and vocal fatigue score) after singing.', 'The purpose of this study was to measure the effect of a straw phonation protocol on acoustic (long-term average spectrum) and perceptual (self-report) measures of the choral sound of an intact soprano, alto, tenor, and bass (SATB) choir.', 'We investigate the effect of inactivated, uni- and bilateral VIM-DBS on speech production in patients with ET.', 'Two different voice stimuli (one calm, the other turbulent) were presented in a\xa0randomized sequence, and physiological parameters (blood pressure, heart frequency, oxygen saturation, respiratory rate) were recorded.', 'Stuttering is a serious health and social problem that can distinctively affect not only the mental development of an individual but also his life possibilities , including social fulfilment and his general life prospects .', 'Standardised comprehensive video tutorials watched frequently throughout practice can significantly improve precision in MIC training.', 'Although our dataset is heterogeneous, it can be concluded that voice stimuli can influence conscious patients.', 'Our findings suggest that this novel treatment protocol is appropriate, engaging and safe for persistent voice hearers.', 'Wearable device technology can be used to enable musically-contingent SIP training to increase motor automaticity for people living with PD.', 'Men who receive low masculinity feedback during the speech task experienced more pronounced vagal withdrawal relative to those who received the control.', 'Computer-based auditory training programmes seem to be a\xa0useful tool in the process of auditory rehabilitation after cochlear implantation (CI).', 'A relationship was demonstrated between age and QTpeak, Tpeak-Tend, QT and QTc.', 'Two hundred and eighty-five undergraduate males were randomly assigned to one of six conditions during a laboratory-based speech task.', 'Thirty-two patients were randomly assigned to either an experimental group (17 patients) treated with computerized rehabilitation training (Power-Afa, Maddaloni, Campania, Italy) or a control group (15 patients), submitted to conventional speech therapy.']


Cluster  955
['Scotland has a serious problem with alcohol .', 'Excessive alcohol consumption poses a serious problem for public health .', 'Alcohol dependence constitutes a serious worldwide public health problem .', 'In summary , substance abuse is a serious problem in America .', 'James Bond has a severe chronic alcohol problem .', 'Overserving and allowed entry of obviously alcohol-intoxicated spectators are problematic at sporting events in Sweden and may contribute to high overall intoxication levels among spectators.', 'Alcohol abuse and addiction is not only a severe social problem , but also an important biological medical issue .', 'Alcohol-induced immune activation and neuroinflammation are a serious health concern for PLWH .', 'Alcohol dependence , a chronic relapsing brain disease with the characteristics of drinking alcohol out of control , has become a serious social problem .', 'Excessive alcohol intake is a serious but preventable public health problem in the United States and worldwide .', 'Hazardous drinking is a serious societal concern in military populations .', 'Alcohol use disorders ( AUDs ) are a devastating public health problem .', 'Each year , 17 million adults experience a serious problem with alcohol , but only 3 million get help .', 'Alcohol-related diseases represent a serious problem all over the world and they show a gradually increasing tendency .', 'Intoxicated aggression is both a dangerous and a costly problem for society , with alcohol being involved in over 50 % of violent crimes , and the cost of alcohol-consumption-related crime being estimated at $ 205 billion in the United States alone .', 'With the exception of Denmark , alcohol has for a long time been regarded as a serious public health problem , and the reduction of total consumption of alcohol has been held as one of the most important ways of combating alcohol problems .', 'Ethanol withdrawal is a serious clinical problem owing in part to over stimulation of ionotropic glutamate receptors in the brain and is linked to elevated oxidative damage .', 'Alcoholism is a serious health problem .', "Alcoholism is a serious public health concern that is characterized by the development of tolerance to alcohol 's effects , increased consumption , loss of control over drinking and the development of physical dependence .", 'Despite the fact that alcoholism is a severe public health problem of worldwide proportions , only a limited number of medications is used as coadjuvant treatment .', 'The prevalence and costs of alcohol and drug disorders pose a serious social concern for policymakers .', 'Alcohol abuse is a serious health problem worldwide that causes a variety of physical and mental disorders .', 'Alcohol use disorder ( AUD ) persists as a devastating public health problem ; widely effective pharmacological treatments are needed .', 'Alcohol abuse is a serious health problem , leading to life-threatening damage to most of the important organ systems .', 'Despite a recent decline in per capita alcohol consumption , alcoholism remains a serious public health problem in France .', 'Alcohol is the most commonly abused legal substance and alcoholism is a serious public health problem .', 'Alcohol consumption is a serious problem in terms of public health because it remains a major cause of illness and premature death .', 'Problems with alcohol remain a serious public health concern despite decreased use among some populations .', 'Harmful alcohol consumption in Germany is a serious public health problem : About 7.7 million adults in Germany can be classified as risky alcohol consumers , about 74,000 deaths per year are related to alcohol consumption , and about 1.8 million adults in Germany ( 18 - 64 \u2009 years ) are classified as alcohol dependent .', 'Alcoholism is a serious public health problem .', 'Alcoholism is a serious public health problem throughout the world .', 'With the number of chronic heavy users of ethanol in the United States estimated to be 15 to 20 million and the evidence increasing that ethanol causes serious cardiac metabolic disturbances , ethanol abuse is obviously a serious problem and most likely is an important contributing factor to cardiac morbidity and mortality .', 'Alcohol use disorders are a serious public health concern among soldiers .']


Cluster  1357
['Both a poster and a mobile healthcare application are effective in delivering dental trauma information.', 'Maxillofacial trauma ( MFT ) is a serious health problem and in Saudi Arabia is mainly caused by road traffic accidents ( RTAs ) .', 'Impacted maxillary canines are a serious problem in orthodontics and prosthodontics .', 'Traumatic dental injuries seem to be a serious dental public health problem among children in deprived areas .', 'Maxillofacial-oral injuries is a serious health problem in China .', 'Traumatic dental injuries ( TDIs ) are a serious public health problem .', 'In conclusion , traumatic dental injury may pose a serious dental public health problem .', 'Prompt management of dental trauma in children affects outcomes, and multiple educational resources are available.', 'Dentoalveolar injuries represent a serious dental problem for the patient .', 'Traumatic dental injuries are widespread and have become a serious dental public health problem in childhood .']


Cluster  1541
['Sudden death ( SD ) is a tragic event and a world-wide health problem .', 'In industrialized countries , sudden cardiac death is a serious public health problem that accounts for about 15 % to 20 % of all deaths , with an incidence of 0.5 to 3 deaths per 100,000 athletes .', 'Cardiac arrhythmia causing sudden cardiac death is a serious worldwide public health problem .', 'Looking forward : PACES Task Force on prevention of sudden cardiac death in the young : a comprehensive approach to a preventable problem .', 'Sudden cardiac death ( SCD ) is a serious public health problem .', 'Although identification of the HCM patient subset at high risk for a catastrophic event with precision continues to present challenges , treatment strategies for the prevention of sudden death are now available .', 'Sudden , unexpected death in CHF patients is also a serious problem in Japan .', 'As the first and only manifestation of ischemic heart disease , sudden unexpected cardiac death ( SUCD ) is a serious clinical and epidemiological concern .']


Cluster  1157
['To assess the impact of resident teaching on student perceptions of a Patient Safety course.', 'A single-blinded randomised controlled trial of medical students counselling simulated patients during a clinical examination.', 'Teaching using standardized patients resulted in a significant albeit small improvement in objective structured clinical examination scores (61.', "This was a randomized prospective pilot study to compare the effect of experiential learning versus traditional PowerPoint learning regarding nurses' attitudes towards performing dysphagia screening in an outpatient setting.", "Teaching management of emergencies using standardized patients can improve medical students' performance in clinical tests, and a change from traditional seminars in favor of practice sessions with standardized patients does not compromise the learning of medical facts.", 'Medical students (n\u200a=\u200a242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings ("acute chest pain," "stroke," and "acute dyspnea/asthma") or traditional small group seminars.', 'We randomly assigned 95 third to fifth year medical students to an intervention group which received instructions according to Peyton (PG) or a control group, which received conventional teaching (CG).']


Cluster  1417
['However , BM comprises the most common site of progressive disease in pts with or without baseline BMs , which is a serious problem for crizotinib .', 'Active vaccination inducing high-affinity antibodies against PCSK9 with less frequent administration intervals may be a novel promising therapeutic approach to overcome the drawback of passive immunization with PCSK9 mAb .', 'However , elevated troponin I at the postischemic phase is a serious concern and its significance needs to be addressed before broad clinical application of HBOC .', 'Secondly , a major problem with the PCSK9 monoclonal antibodies is that they are expensive , and their use is often discontinued or not pursued , which can leave the subjects intended for treatment at high cardiovascular risk .', 'The low PAD yield and the fact that QRISK2 was largely comparable to the ABI in predicting high CV risk suggests that routine PAD screening may be unwarranted.']


Cluster  669
['The objective of the present prospective randomized clinical study was to compare the overall treatment outcome following immediate loading (IL) and delayed loading (DL) of single implants after 1 year of follow-up.', 'These results, suggest that in both delayed loading and immediate loading protocol that cross arch prostheses can be successfully supported by 3 and 2 implants in maxillary and mandibular arch respectively-"Simpli5y" concept of full mouth restoration.', 'The study population was 16 patients with edentulous anterior maxillary alveolar ridges (40 implant sites).', 'For anterior single tooth replacements, scalloped implants show less favorable radiographic and clinical outcome compared to regular implants with a smooth neck or rough neck.', 'Immediate loading of reduced-diameter implants supporting locator-analog attachments resulted in high implant survival, few prosthetic complications, good oral hygiene, and improvement of subjective denture perception in the short-term.', 'Stabilization and retention of most of the mandibular full dentures constitute a serious problem for patients and dentists .', 'In 24 patients with 24 single-tooth implants, 2 types of reconstructions were fabricated: a directly veneered one-piece zirconia abutment/crown (control) and a directly veneered fluorescent hybrid zirconia abutment/crown (test).', 'The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement.', 'This prospective randomized study showed that single implants in the maxilla can present satisfactory results with respect to either immediate loading or delayed loading after 12 months.', 'Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients.', 'To assess clinical and radiographic outcomes of 6 mm-short implants placed in the posterior maxilla and mandible applying an early loading protocol.', 'Survival of conventionally and immediately loaded 2-piece reduced-diameter implants in the interforaminal region of the edentulous mandible supporting locator-analog attachments was evaluated.', 'Within the limitations of this study and considering a follow-up time of 5 years, it can be concluded that tilted implants behave similarly with regards to marginal bone loss and implant success in comparison to axial implants in full-arch rehabilitation of the maxilla.', 'To compare the 5-year radiographic and clinical outcome of single anterior implants provided with a smooth neck, a rough neck or a scalloped rough neck.', 'CAD/CAM-produced monolithic implant crowns out of LS2 in a complete digital workflow seem to be a feasible treatment concept for the rehabilitation of single-tooth gaps in posterior sites under mid-term observation.', 'To evaluate the clinical outcome of "simpli5y" concept where in 3 and 2 implant placed cross arch in maxilla and in mandible respectively, restored with screw retained prosthesis.', 'Total of 30 patients were randomized, with 15 in group1 with an average of 45 Ncm insertion torque with delayed loading and 15 in group 2 with above 65 Ncm inertion torque with immediate loading with equal number of male and female in each group following parallel design with 3 implants in maxillary and 2 implants in mandibular arch placed which was supported by a 3Dimensional finite analysis comparing the stress dissipation around implants of this concept-"Simplif5y" with All-on-4 concept.', 'Both types of implant reported high survival rates and similar bone level changes, clinical parameters, and patient related outcomes after 12 months of loading.', 'This study indicates that dental implants that are inserted after tooth extraction and immediately loaded may constitute a successful and predictable alternative implant treatment.', 'The analysis included 60 implants (Dentium SuperLine, Suwon, Korea) in 30 patients (23 women and 7 men) aged 25-69.', 'The retrospective clinical study included 891 patients with 3564 maxillary implants rehabilitated according to the All-on-4 treatment concept.', 'Partially edentulous patients willing to receive one or two implants in the posterior maxilla or mandible were randomized to the control (TG) or to the test group (SP).', 'Comparison of marginal bone loss and implant success after a 5-year follow-up between axial and tilted implants inserted for full-arch maxillary rehabilitation.', 'Twenty-five patients with adapted complete dentures received 4 reduced-diameter implants.', 'This prospective study aimed to compare immediate and conventional loading of four interforaminal implants supporting a Locator-retained mandibular overdenture in elderly patients regarding implant survival, implant stability, and implant-related complications.']


Cluster  2164
['Body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA) score, hemoglobin, serum albumin, serum prealbumin, CD4 and CD8 T cell counts, CD4/CD8 ratio, IgA, IgG, and IgM showed no significant difference between EN group and control group at discharge (all P>0.', 'The RCA method can improve clinical efficacy, relieve negative emotion, reduce the incidence of complications, and improve the level of satisfaction with nursing of elderly patients with AP.', 'Primary care providers should perform a comprehensive assessment of patients prior to their discharge.', 'AOS in a PHC is safe and should be more encouraged in the public primary care.', 'Acute PE in the South-East Asian patients is associated with an overall mortality rate of 5%.', 'In this large and heterogenous medical ED patient cohort, admission PCT was a strong and independent outcome predictor for 30-day mortality across different medical diagnoses independent of underlying infection.', 'Although it is a serious clinical problem for HIV/AIDS patients , comparative analyses of ER stress induction by clinically used PIs have rarely been done .', 'To evaluate to which extent patients and physicians understand and accept risks associated with NAT treatment.', 'There was an increased awareness of the impact of NWE on patient outcomes, in particular, related to safety and quality of care']


Cluster  592
['The analysis showed that suicide continues to be a serious problem in later life especially among the " oldest-old " ( those aged 85 and over ) and among nonwhite males .', 'This study emphasizes the importance of a rapid and active outreach intervention and points out that the effect on the number of patients repeating a suicide attempt wears off and is no longer sustainable after 3-4 years, suggesting the need for a follow-up intervention.', "This study examined the impact of a 6-hr continuing education training, and the effect of a posttraining reminder system, on mental health practitioners' knowledge, attitudes, and behavior surrounding suicide assessment and intervention.", 'Consultant pharmacists need to be aware that suicide is a serious concern for elders .', 'An observational study of self-reported suicidality (C-SSRS), psychological distress (K10), and resiliency (READ) in three adolescent samples: suicide clinic (N = 147); general psychiatric clinic (N = 85); and a nonclinical sample (N = 92).', 'Offering OPAC intervention to patients after a suicide attempt has a significant preventive effect on the total of suicide attempts and significantly reduces the number of patients repeating a suicide attempt.', 'Suicide attempts are a serious public health concern with devastating global impact , thereby necessitating the development of an adequate prevention strategy .', 'Suicide in the older people is a serious problem worldwide ; however the effect of psychiatric contact on the risk of suicide has not been fully explored .', 'These findings suggest that anxiety disorders are independent risk factors for suicide attempts , and underscore the importance of anxiety disorders as a serious public health problem .', 'This time lag is a serious concern for the healthcare community when dealing with patients with suicidal thoughts .', 'In consideration of the information already available and the findings reported in this study , attempted suicide attempts appear to be a < < symptom > > and not a pathology , at which basis different psychopathological profiles can be found : it is a symptom of a serious emotional and relational problem , which rarely reveals itself suddenly and even more rarely is resolved without help .', 'With the population of the elderly increasing , suicides among elderly people present a serious problem for global societies .', 'Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources .', 'All practitioners demonstrated increase s in suicide assessment knowledge and attitudes for engaging in suicide risk assessments from pre- to posttest, and gains were maintained at the 3-month follow-up.', 'Attempted suicide is a serious problem requiring mental health interventions , but it continues to be treated as a criminal offence under the section 309 of Indian Penal Code .', 'The analyses were carried out on 163,331 calls, of which 1,380 calls were due to suicidal behaviour (0.', 'Suicide attempts ( SA ) constitute a serious clinical problem .', 'Inadequate training of nurses in suicide assessment and prevention is a serious patient safety concern .', 'A problem with past research is that it has not adequately incorporated mediating and moderating variables into pathways that link psychosocial stressors and suicidal outcomes .', 'The results indicated differential characteristics of suicide calls that are potentially relevant for prevention in spite of the limitations of the present study.']


Cluster  1663
['The results supported the idea that concentration polarization effects at the endodermis ( internal USLs ) cause a serious problem whenever relatively large amounts of water ( xylem sap ) are radially moved across the root , such as during PC or when using the high-pressure flow meter technique .', 'However , somaclonal variation occurred during micropropagation process posed a severe problem by affecting product quality .', 'A serious problem in the technology of plant cell culture is that isolated protoplasts from many species are reluctant to divide .', 'Somaclonal variation can pose a serious problem in any micropropagation program , where it is highly desirable to produce true-to-type plant material .']


Cluster  1139
['It is a serious problem troubling women at the reproductive age .', 'Pregnancy in adolescence constitutes a serious public health problem at these ages .', 'Unintended pregnancy is a serious concern in reproductive health which needs to be addressed .', "Adolescent pregnancy , occurring in girls aged 10 - 19 years , remains a serious health and social problem worldwide , and has been associated with numerous risk factors evident in the young people 's family , peer , school , and neighbourhood contexts .", 'Background Teenage pregnancies constitute a serious health and social problem worldwide .', 'Sexually transmitted diseases , including AIDS , and unplanned pregnancies continue to be a serious worldwide problem .', "The rise in teenage pregnancy and young people 's vulnerability to HIV have been a serious problem .", 'Teenage pregnancy has become a serious public health problem , particularly in developing countries with limited obstetric facilities .', 'Teenage pregnancy is a socio-economic challenge and a serious public health problem for communities in South Africa .']


Cluster  2379
['Arsenic created a serious public health problem in Bangladesh due to its presence in groundwater and dissemination of the toxic effects to millions of people .', 'Arsenic contamination in groundwater from crystalline basement rocks in West Africa has only been documented in isolated areas and presents a serious health threat in a region already facing multiple challenges related to water quality and scarcity .', 'Arsenic concentrations of tubewell water that exceed acceptable limits poses a serious health problem in Bangladesh .', 'The contamination of arsenic in human drinking water supplies is a serious global health concern .', 'Arsenic contamination of ground water has become a serious problem all over the world .', 'Exposure to arsenic via drinking water is a serious health concern in the US .', 'Water sources pollution by arsenic ions is a serious environmental problem all around the world .', 'Arsenic in groundwater is a serious problem in New England , particularly for domestic well owners drawing water from bedrock aquifers .', 'Arsenic poisoning from drinking groundwater is a serious problem , particularly in developing Asian countries .', 'Arsenic ( As ) contamination in soil and groundwater has become a serious problem to public health .', 'Arsenic ( As ) contamination of the groundwater in the Mekong Delta is a serious problem affecting millions of people who rely on this important resource for drinking and agriculture .', 'In the Red River Delta , Vietnam , arsenic ( As ) contamination of groundwater is a serious problem where more than seventeen million people are affected .', 'Naturally occurring arsenic in groundwater in Cambodia is a serious health concern .', 'Arsenic contamination of drinking water is a serious water quality problem in many parts of the world .', 'The extensive extraction of arsenic (As)-contaminated groundwaters for drinking , household and agricultural purposes represents a serious health concern in many districts of Bangladesh .', 'Arsenic contamination of groundwater is a serious concern worldwide .', 'Human exposure to drinking water contaminated with arsenic is a serious global health concern and predisposes to cardiovascular disease states , such as hypertension , atherosclerosis , and microvascular disease .', 'Arsenic contamination of soil and groundwater is a serious problem worldwide .', 'Globally , arsenic contaminated groundwater is a serious concern for human health .', 'Arsenic in drinking water is a serious problem for human health .', 'Arsenic ( As ) contamination of water is a serious problem in developing countries .', 'Arsenic pollution of groundwater is a serious problem in many regions of Latin America that causes severe risks to human health .', 'Arsenic contamination in groundwater is a severe global problem , most notably in Southeast Asia where millions suffer from acute and chronic arsenic poisoning .']


Cluster  2326
['Although , whole body ( cardiac ) survival improves to 30 % following recent use of emergency cardiopulmonary bypass , sustained neurological dysfunction remains a devastating and unresolved problem .', 'Brain injury after cardiac surgery is a serious concern for patients and their families .', 'Ventricular conduction disturbances following cardioplegic arrest remains a serious , yet unsolved problem .', 'Neurological damage is a serious problem after cardiac arrest and resuscitation .', 'Cerebral injury after cardiac surgery is now recognized as a serious and costly healthcare problem mandating immediate attention .', 'Neuropsychological disorders and brain injury are still a serious problem in cardiac surgery patients .']


Cluster  48
['Evaluating the efficacy of intravenous (IV) paracetamol as pre-emptive analgesia compared to preventive post-treatment administration in pediatric dental setting.', 'Randomized, double-blinded, placebo controlled trial, testing paracetamol to diminish the pain, and discomfort during mammography.', 'However , a major drawback of sedation with the use of propofol is its high incidence of injection pain .', 'Intra-pocket administration of 20% benzocaine gel may be effective for pain control during SRP and may offer an alternative to conventional injection anesthesia.', 'Oral midazolam syrup is easier for parents to administer and has better medication acceptance in children when compared to intranasal midazolam spray.', 'Buffering local anaesthetics used in caruncular injection for eye surgery significantly reduces pain during injection.', 'Administration of IV paracetamol pre-emptively provides lower pain scores, and a decreased percentage of children required pain relief and less amount of postoperative opioids, compared to preventive administration.', 'Reducing pain on injection of anesthetic drugs is of importance to every anesthesiologist.', 'The use of paracetamol can reduces the mild pain for women undergoing mammography.', 'The incidence and severity of rocuronium-induced injection pain were significantly alleviated via use of a large vein for rocuronium injection.', 'The purpose of this study was to compare pain levels caused by three types of anesthesia injections and the effect of the Dentalvibe<sup>®</sup> on reducing the injection pain.', 'One problem with it is that the insertion of a cotton-tipped applicator soaked in local anesthetic is painful .']


Cluster  2381
["Nurses' perception of competence in spiritual care has critical effects on their own practice", "When advanced practice nurses (APNs) encounter the need to address a bereaved individual's spirituality, gaps in educational preparation may prevent effective intervention"]


Cluster  537
['Hip instability leading to subluxation or dislocation is a serious problem in children suffering from CP and is usually worse in severe condition .', 'Slipped capital femoral epiphysis (SCFE) is a frequent disorder of the adolescent hip, which may lead to avascular necrosis (AVN) of the femoral head, chondrolysis and early osteoarthritis due to the post-slip deformity of the proximal femur', 'Avascular necrosis of the hip is a serious clinical problem encountered by primary care physicians .', 'Chronic instability of the knee joint is a serious problem for the affected patient and the attending physician .', 'Despite advances in the field of orthopedic surgery , necrosis of the femoral head still remains a serious problem .', 'Such gross knee contractures together with the coexisting hip flexion contractures create a severe nursing problem .', 'Patellar dislocations are a common orthopedic emergency with several variants', 'Osteonecrosis of the femoral head is a serious orthopedic problem .', 'Knee dislocation with a common peroneal nerve injury is a serious problem .', 'Persistent instability after hip revision is a serious problem .']


Cluster  1121
['Patient delay appears to be a serious problem in this rural area with a high prevalence of tuberculosis .', "Despite recent efforts , a large proportion of newly confirmed TB patients could not adhere to standard TB treatment , and patients ' lost to follow-up was still a serious problem .", 'Nine months of isoniazid therapy is the recommended regimen for treatment of latent tuberculosis infection , but low completion rates are a serious problem .', "The study concludes that ' system ' delay is a serious problem , which is influenced by the financing mechanisms for both TB control and general health services as well as poverty and disadvantage amongst patients .", 'In settings where TB continues being a serious health problem , cost-effectiveness evaluations would privilege TST under certain conditions : supply of quality-assured PPD reagent , standardized criteria for TST application , reading and interpretation , and regular availability in health centers countrywide .', "The incidence of tuberculosis has decreased in Japan , and , many doctors did not show concern on , thus , a doctor 's delay is a serious problem in Japan .", 'Our data reinforce the concept that loss to follow-up in drug-resistant tuberculosis is a serious public health problem , and that adequate follow-up of treatment is necessary in patients with this history and low schooling .', 'Treatment default is a serious problem in tuberculosis control because it implies persistence of infection source , increased mortality , increased relapse rates and facilitates the development of resistant strains .']


Cluster  1668
['Violence by patients is a serious concern in psychiatric hospitals and staff are the most frequent targets of physical and verbal assault .', 'Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff ( MHS ) is a serious concern facing psychiatric hospitals .', 'Psychiatric patient assaults on staff are a serious problem , affecting staff , patients , and organizations .', 'Violence is a serious problem in psychiatric services and staff experience significant psychological reactions to being assaulted . Health and Safety Authorities in the UK and Ireland have expressed concern about violence and assault in healthcare , however , there remains a lack of clarity on matters of procedure and policy pertaining to safety and security in psychiatric hospitals .', 'Patient aggression is a serious problem in psychiatric nursing .', 'Assaultive behavior by patients is a serious problem throughout healthcare facilities .', 'The nature , severity and health impact of this violence represents a serious safety concern for mental health employees .', '1 . Assault directed against psychiatric staff is emerging as a serious occupational health problem .', 'Despite prevention and intervention measures , experts predict that assault in hospitals will continue to be a serious problem .']


Cluster  1336
['High-voltage electrocution injuries are a serious problem with potential for both immediate and delayed neurologic sequelae .', 'Electrocution is a serious public health concern and reported worldwide with few fatal ending .', 'Electrical burn injuries continue to be a serious problem of modern society .', "Exposure to electrical current via industrial or residential accidents or lightning strikes is a serious and growing concern in today 's medical community .", 'High-voltage electrocution injuries are a serious problem with potential for immediate , delayed , and long-term neurologic sequelae .']


Cluster  21
['It features all the capabilities of the closed sourced Pharaoh decoder -LRB- Koehn 2004 -RRB- . it was developed for English , and adapting it to other languages would involve a major redesign and adaptation of the system', 'Training Low-level Matching Features The rather abundant original -LRB- post , response -RRB- pairs provide rather rich supervision signal for learning different matching patterns between a post and a response . its reliance on a robust syntactic/semantic analysis to find the focus on which all the IRs depend', 'While the helicopter is airborne , an on-board active vision system will interpret the scene below to interpret ongoing events , which may be reported -LRB- via NL generation -RRB- to the operator . it simply models the text-to-word information without leveraging the correlation between short texts', 'Using LSTM units , we demonstrate that our model can effectively learn to diacritize Arabic texts and rivals state-of-the-art methods that rely on language-specific tools . the minimal expressiveness of the input language : user requests must be expressed as a conjunction of simple relations ( literals ) , equivalent to the select/project/join operations of a relational algebra', 'Keyboard communication patterns , upon which most natural language heuristics and algorithms have been based , also are contrasted with patterns observed in the two speech modalities . the user may have to read a large number of reviews in order to make a decision', '1993 -RRB- and information retrieval -LRB- Franz , M. and McCarley , S. 2002 -RRB- . WIT cannot deal with multiple speech recognition candidates such as those in an N-best list', 'Given a natural language question , our IR system returns a set of matching passages , which we then rank using a linear function of seven predictor variables . it requires considerable linguistic skill to produce proper rules in a proper order', 'SRN is not very different from JRN as shown in Figure 4b . it is impossible to adapt them to a specific task , which could generate many errors that are important to the task', 'low-bandwidth , low-quality VoIP channel -RRB- , from a language modelling perspective -LRB- e.g. . the corpus is not publicly available yet', 'While the helicopter is airborne , an on-board active vision system will interpret the scene below to interpret ongoing events , which may be reported -LRB- via NL generation -RRB- to the operator . it simply models the text-to-word information without leveraging the correlation between short texts', 'HVR is designed for modern mobile devices equipped with an embedded microphone to capture speech signals and a touchscreen display to receive touch events . computation for the MSZ relevance score ranking is intractable due to the number of n-grams']


Cluster  1844
['AF is a serious clinical problem associated with increased morbidity and mortality , mainly due to stroke and heart failure .', 'Compared to AAAF after stroke, known AF was associated with embolic stroke.', 'This trial will provide information on the value of ICMs to detect subclinical AF in patients with stroke presumed due to large vessel atherosclerosis or small vessel disease, which will have implications for guiding treatment with oral anticoagulation for secondary stroke prevention.', 'Mortality within 30days after the index event was significantly lower in patients with paroxysmal AF than with chronic AF (7.', 'Approximately 70% (n=142) of the 204 patients presenting 6-24\u2009hours after last known well with NIH Stroke Scale score ≥6\u2009and harboring an ACLVO are DAWN and/or DEFUSE-3 ineligible, most commonly due to large infarct burden (38%).', 'The incidence of occult AF is high in Asian patients with cryptogenic stroke and comparable to western cohorts.', 'STROKE-AF is a randomized, controlled, open-label, post-market clinical trial.', 'Between October 2002 and July 2009, those who were diagnosed with AF (n=354) were enrolled in our study out of a total of 2026 acute ischemic stroke (IS) patients.', 'A significant proportion of strokes in AF patients occur in patients with paroxysmal AF, but they have better prognosis than patients with chronic AF.', 'The aim of this study was to compare the embolic stroke in patients with known AF and after-admission AF (AAAF).']


Cluster  634
['Ninety-seven patients with mild-to-moderate dementia (Mini-Mental State Examination: 21.', 'The dramatic increase in the number of older people with Mild Cognitive Impairment ( MCI ) entails a serious public health problem .', 'Information about the epidemiology of dementia in Italy is still limited , although this cognitive disorder represents a serious public health concern .', 'Altered mental status (AMS) is a challenging diagnosis in older patients and has a large range of etiologies.', 'A diagnosis of dementia confers an increased risk of either death or further admission within the following 12 months, highlighting the need for better cognitive screening in the acute setting, as well as targeted intervention such as comprehensive geriatric assessment.', 'Loss of cognitive function is a feared age-associated condition and growing public health concern .', 'The difference between the findings of the PP and ITT analyses may be explained in part by the different distribution of severity of dementia in the two groups (experimental and control).', "But the very success of this widespread acceptance and popularization has produced a troubling dilemma regarding the subjectivity of the person diagnosed with Alzheimer 's disease .", '-LRB- 2002 -RRB- were among the first to apply automated methods specifically to scoring the WLM subtest and determining the relationship between these scores and measures of cognitive function . they are inefficient to train with large-scale , especially large category data', 'The absence of validated and culturally adapted assessment tools for the Luxembourgish context is a serious problem in the diagnosis of cognitive deficits of either origin .', 'Increasing prevalence of cognitive impairment in an aging canine population poses a serious health problem .', 'Both montreal cognitive assessment score change (Month12 [M12]-baseline; P\u202f=\u202f.', 'In atypical cases of dementia, biomarkers significantly raise diagnostic accuracy, confidence, and agreement.']


Cluster  651
['The recent decline in fertility is a serious problem in the dairy industry .', 'Digital dermatitis is a serious problem in dairy production in many countries .', 'This poses a serious problem for the US dairy industry .', 'Milk antimicrobial residues are a serious concern for the dairy industry .', 'Human error often becomes a serious problem in dairy life .', 'Udder infections with environmental pathogens like Escherichia coli are a serious problem for the dairy industry .', 'As demand for milk-derived products is increasing , it leads to increased production of whey , which poses a serious management problem .', 'A major drawback of using dairy slurry as fertilizer is that it may contains pathogens such as Mycobacterium avium subsp . paratuberculosis ( MAP ) , and it could represent a risk to animal and public health .']


Cluster  531
['The mean Survey of Academic Self-Regulation (SASR) scores between groups was significant, p\u202f=\u202f.', 'The three extracted factors cut across the traditional dichotomy between intrinsic and extrinsic motivation and uncover a novel three-faceted motivation construct based on scientific factors, societal expectations and humanitarian needs.', "Results revealed that (1) the effect of teacher structure on students' autonomous motivation was positive only when differentiated instruction strategies were frequently used, and this moderated effect was partially mediated by perceived competence, and (2) teacher structure was negatively associated with students' controlled motivation only when differentiated instruction was provided infrequently, and this moderated effect was not explained by perceived competence.", 'Although the importance of fostering students self-regulated learning is well known, little is known about the relationship between student entry characteristics, particularly students from disadvantaged backgrounds, self-regulatory strategy use and academic performance', 'Each type of motivation has different but related predictors.', 'To compare the academic background and self-directed learning behavior of students who entered to a public medial school between 2010 and 2014.']


Cluster  1458
['Pre-harvest sprouting ( PHS ) , the germination of grain before harvest , is a serious problem resulting in wheat yield and quality losses .', 'The premature germination of seeds before harvest , known as preharvest sprouting ( PHS ) , is a serious problem in all wheat growing regions of the world .', 'Pre-harvest sprouting , the germination of mature seeds on the mother plant under moist condition , is a serious problem in cereals .', 'Pre-harvest sprouting ( PHS ) , a term mainly used to describe the phenomenon in which grains germinate on the mother plant directly before harvest , is a serious global problem for agricultural production .', 'Pre-harvest sprouting ( PHS ) during wet and cool harvest periods remains a serious problem in the production of cereals like barley , wheat and triticale .']


Cluster  45
['The women in this study described gaining benefits from acupuncture that they felt enabled them to better manage their lives and the changes that pregnancy brings.', 'According to the finding of this study, it seems that acupressure treatment was not effective in initiating labor as compared with the sham acupressure and the routine care groups.', 'Acupuncture proved to be an excellent alternative to catheterization in treatment of women with postpartum urinary retention.', 'Evidence for treating infantile colic with acupuncture is contradictory.', 'A double blind sham controlled acupuncture study was conducted with Rome I IBS patients receiving twice weekly true acupuncture for 4\xa0weeks (n=43) or sham acupuncture (n=36).', 'The aims of the present study were to evaluate acupuncture as an alternative treatment to an indwelling catheter for women with postpartum urinary retention, and to evaluate the accuracy of sonographic estimation of bladder volume by portable bedside equipment in women postpartum.', 'The lack of differences in symptom outcomes between sham and true treatment acupuncture suggests that acupuncture does not have a specific treatment effect in IBS.', 'Reflexology application for babies suffering from infantile colic may be a promising method to alleviate colic severity.']


Cluster  2165
['A drawback of this strategy is represented by the extremely weak interactions that require low temperature and high pressure .', 'As such , the use of AI in molecular simulations can suffer from a dangerous situation where the AI-optimization could get stuck in spurious regimes , leading to incorrect characterization of the reaction coordinate ( RC ) for the problem at hand .', 'The degree of electronic and nuclear coupling in the Cl + H2 reaction has become a vexing problem in chemical dynamics .', 'The unknown amount of hydrodynamically coupled liquid is a serious problem in the interpretation of QCM experiments .', 'We then show that the problem with MD simulations is that they measure water-to-bilayer free energies , whereas the molecular biology experiments measure the energetics of partitioning from translocon to bilayer , which raises the fundamental question of the relationship between water-to-bilayer and water-to-translocon partitioning .', 'The main problem with this approach is that it may take an excessively long time for the nuclear polarization to approach thermal equilibrium at low temperatures , since nuclear relaxation becomes exceedingly slow due to the loss of molecular motion .']


Cluster  2078
['Ventricular septal rupture ( VSR ) complicating acute myocardial infarction ( AMI ) is a serious clinical problem with high mortality rate due to cardiogenic shock or prolonged hemodynamic compromise .', 'Right ventricular ( RV ) failure is a serious common clinical problem that is poorly understood .', 'Ventricular rupture following myocardial infarction is a serious clinical problem with a high mortality .', 'It is certainly a serious problem , but early diagnosis and supporting angiography to rule out the presence of an associated left ventricular malformation and to check the volume of the left ventricular cavity should lead to a decision to operate .', 'Iatrogenic right ventricular failure in tetralogy of Fallot repairs : reappraisal of a distressing problem .', 'Biventricular failure and total artificial heart : Old and new solutions for a vexing problem .']


Cluster  1338
['The results indicate that 2 × 200 mg WS® 1375 may be an effective treatment in subjects suffering from prolonged or chronic fatigue.', 'Fatigue is a serious problem for individuals experiencing chronic illness that can cause difficulties managing self-care activities and achieving quality of life .', 'Change of Modified Fatigue Impact Scale (MFIS) between Fg treatment start and at 6 months was used as a first outcome.', 'There is no significant impact of Fg on fatigue after 6 months of treatment.', 'The main reasons for referral to rehabilitation were: fatigue (86.', 'This study suggests that there is an association between urinary carnitine levels and self-reported fatigue.', 'The post intervention measures were significantly different to the pre-intervention results for the time to fatigue (post-pre: 20.', 'As fatigue is becoming a serious problem in the modern society affecting human health , work efficiency , and quality of life , effective antifatigue remedies other than pharmacological drugs or therapies are highly needed .', 'The difference in physical fatigue score was -0·97 (95% CI: -1·65; -0·28, P\xa0=\xa00·006) in favour of intravenous iron, but did not meet the predefined difference of 1·8.', 'Baseline results indicated that fatigue is a severe problem for 28 % of the investigated patients .', "Fatigue is a severe problem for many people living with Parkinson 's disease ( PD ) .", 'Acute-phase fatigue was associated with activity limitations at 18-month follow-up (P\u2009=\u2009.']


Cluster  1473
['Entero aggregative Escherichia coli ( EAEC ) is an emerging enteric pathogen associated with acute and persistent diarrhea and the evolution and spread of acquired extended spectrum betalactamases ( ESBLs ) among these strains has become a serious problem in the management of infectious diseases in developing countries .', 'The inappropriate use of antimicrobials for acute infectious diarrhea is widespread and leads to the problem of antimicrobial resistance', 'In an observational study based on the Copenhagen intestinal failure database, all clinically reported CRBSIs from 2002-2013 were compared with data from the affiliated microbiological database according to recommended CRBSI criteria.', 'Diarrhea-causing Escherichia coli strains are responsible for numerous cases of gastrointestinal disease and constitute a serious health problem throughout the world .', 'Gastrointestinal infections are considered a serious public health problem in view of their high incidence and the increasing antibiotic resistance of the microorganisms involved in their pathogenesis , namely Escherichia coli .', 'Toxic megacolon complicating pseudomembranous enterocolitis is a serious problem that carries a high morbidity and mortality rate , regardless of treatment .', 'Escherichia coli strains are responsible for many cases of gastrointestinal disease and represent a serious health problem worldwide .', 'High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem .', 'Infection caused by enterotoxigenic Escherichia coli ( ETEC ) poses a serious health problem to children in developing countries .', 'This may pose a severe problem as intestinal Enterobacteriaceae members are commonly implicated in human infections .']


Cluster  34
['Eighteen healthy volunteers (12 men, 6 women) participated.', 'In all, 10 patients were included in the study.', 'Twelve healthy male subjects were enrolled.', 'Twelve patients completed the protocol.', 'Twelve healthy individuals (8 male; mean age 21.', 'Twelve males (age 22±2 years; stature 1.', 'The study included 12 patients, all of whom suffered from at least one adverse event.', 'Twelve subjects were assigned to each cohort.', 'Ten patients were enrolled.']


Cluster  2347
['Extravasation of chemotherapeutic agents such as doxorubicin results in significant morbidity and remains a serious clinical problem .', 'Adriamycin extravasation is a serious problem that can lead to severe local necrosis and damage to underlying nerves , tendon , and muscle .', 'Extravasation tissue injury from chemotherapeutic drugs is a serious clinical problem .', 'With the advent of parenteral , intravenous infusion for various purposes like chemotherapy , parenteral nutrition , radiocontrast intravenous injection for imaging studies , extravasation injuries are emerging as a serious problem with often disastrous complications , if not recognized early .']


Cluster  228
["Propofol anesthesia by target-controlled infusion was effective and didn't show serious propofol-related perioperative adverse events.", 'The optimal depth of conscious sedation during FB for conventional examination was achieved at an RSS of 4.', 'Thirty-one children completed all assessments; 12 underwent caudal block, 9 IV fentanyl anesthesia, and 7 were given penile block.', 'The concentrations found are safe for infiltrative anesthesia in the analyzed patients, there was a higher plasma level of the local anesthetic in the anterior region of the maxilla and there was no change in HR and BP in relation to the anesthetized area.', 'The course of general anaesthesia with the use of the EtC module was analysed for haemodynamic stability, depth of anaesthesia, end-expiratory concentration of anaesthetic, number of ventilator key presses, fentanyl supply, consumption of volatile agents and anaesthesia and operation times.', 'Neuromuscular relaxants are essential during general anesthesia for several procedures.', 'Forty-one patients underwent sedation including ketamine (63.', 'Growing evidence indicates that ketamine causes neurotoxicity in a variety of developing animal models , leading to a serious concern regarding the safety of pediatric anesthesia .', 'Retrobulbar block is safe and effective as an alternative to systemic fentanyl and could provide better pain management, hemodynamic suppression, and stress response suppression in pediatric vitreoretinal surgery.', 'Ketamine is as safe and effective as fentanyl for adult analgesia and sedation during FFB.', 'Though propofol is a widely used anesthetic agent in day-care procedures due to its rapid onset and quick recovery has a drawback of requiring resuscitation maneuvers more often than the conventional methods .', 'Toxicity of local anesthetics is a serious concern by anesthesiologists while performing regional anesthesia .', 'To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor procedures and cardiac catheterisation under sedation for various congenital heart diseases.', '50 children aged 2-14 years undergoing deep sedation were randomly assigned to 2 groups: (A) watching or (B) not watching a standardized videoclip during sleep induction with propofol.', 'The median sleep induction dose of propofol did not differ in both groups (A: 1.', 'Proportionate palliative sedation and the giving of a deadly drug : the conundrum .', 'A total of 109 patients anesthetized with propofol (propofol group) were compared with 109 patients with volatile anesthetics (volatile group) after propensity score matching.', 'This was a prospective randomized trial of adult patients (n=80) undergoing FFB, randomized to receive sedation with either KPM (n=39) or FPM (n=41).', 'Serotonin level at the anesthetic induction was 24.', 'Seventy-four patients underwent general anaesthesia for scheduled operations.']


Cluster  674
['AHC remains a serious public health problem in Southern and Eastern China that mainly affects farmers and children younger than 9 years .', 'Health problems among children with CHDs travelling abroad are mainly related to chronic disease exacerbations, which mostly occur after the children return.', 'NPDI-FHF is not a common problem in Scotland , but it is a serious problem for those affected and consumes considerable health care resources .', 'In China , HFRS has been recognized as a severe public health problem with 90 % of the total reported cases in the world .', 'In conclusion , the rate of SI among HCWs is high in China and SI represents a severe but largely neglected problem .', 'Vital statistics in South Asia are not reliable , and this leads to an underestimation of the magnitude of RTIs that hampers efforts for its acceptance as a preventable public health problem .', 'With rapid ageing in China , PAD has become a serious public health problem .', 'High altitude polycythemia ( HAPC ) is a serious public health problem among Han Chinese immigrants to the Qinghai-Tibetan Plateau .', 'HF remains a serious public health problem worldwide , with increasing age-standardized prevalence and YLD rates in countries with relatively low SDI .', 'NIHL is a serious health problem in Asia , not only because of the number of affected labourers , but also because the majority of Asian countries are still developing economies where access to health services and preventive programmes are limited .', 'From the results we came to conclusion that in the territory of Republic of Kosovo , the HFRS is still a serious health , economic and biological problem .', 'Inadequate daily intake of energy and nutrients of most of the children , in combination with parasitic infections , still common in rural northeast Thailand , was shown to result in a serious public health problem .', 'This presents a serious health problem in northeastern and northern Thailand .', 'The CHD among live infants seemed to be a serious health problem in Shaanxi province as well as in Northwestern China .']


Cluster  655
['Data were collected from 19 patients with a median age of 8.', 'The 1-year prevalence of STP use was 7.', 'The average age of patients was 9.', 'STD prevalence was 13.', 'The prevalence of dental agenesis was 9% (9.', 'The incidence of definite early ST was 19.']


Cluster  781
['Both Kinesio taping and therapeutic exercise improve forward head posture after intervention and a 2-week follow-up.', 'Kinesio® taping in chronic low back pain is an easy and effective method which increases the effectiveness of the treatment significantly in a short period when applied in addition to exercise and electrotherapy methods.', 'Kinesio taping played a vital role in improving functional outcomes compared to orthotics by reducing pain and improving functional activity in patients with shin splint; however, navicular drop correction did not occur using either intervention.', 'Results showed that KT may effectively reduce pain and disability.', 'KT reduced analgesic need of patients with LDH when compared with placebo taping.', 'KT has been found to be more effective than postural exercises to reduce neck disability.']


Cluster  146
['Dyspnea ( breathing discomfort ) is a serious and pervasive problem that can have a profound impact on quality of life .', 'Breathlessness or " shortness of breath , " medically termed dyspnea , remains a devastating problem for many people and those who care for them .', 'Thirty patients with advanced cancer having unresolved breathlessness were recruited from Hospice and Palliative Care Centre of Kiang Wu Hospital in Macau.', 'Hamilton Depression Scale and Hamilton Anxiety Scale scores in the observation group were lower than those in the control group, and the levels of various pulmonary function indicators including degree of blood oxygen saturation, forced expiratory volume in 1 second, forced vital capacity and maximum ventilatory capacity and quality of life scores were significantly improved; compared with the control group, the total compliance of the observation group was significantly increased, and the difference between the two groups was statistically significant (P\u2009<\u20090.', 'Phase 2 clinical trial to assess the clinical feasibility and outcome of using an electric fan to alleviate the symptom of dyspnea in Chinese patients with advanced cancer.', 'Opioid-related respiratory depression ( RD ) is a serious clinical problem as it causes multiple deaths and anoxic brain injuries .', 'Death and anoxic brain injury from unrecognized postoperative respiratory depression ( PORD ) is a serious concern for patient safety .', 'The present study will be the first multicener study to evaluate the efficacy and safety of Maekmoondong-tang for postoperative cough in patient with lung cancer surgery.', 'Respiratory depression (defined as a persistent respiratory rate <10 breaths/min or persistent oxygen desaturation <92%) was observed in 5 of 15 patients in group F after laryngeal mask airway was removed in the operating room, compared with none in group RB.']


Cluster  819
['The hospital infections associated with surgical procedures and implants still represents a severe problem to modern society .', 'The infection of orthopedic implantation devices with Staphylococcus has been a serious concern within the biomaterial community .', 'Bacterial infection is a serious medical problem leading to implant failure .', 'Implant related nosocomial infections are a serious public health concern .', 'Bacterial infection associated with prosthesis implantation , or even along the lifetime of the implanted prosthesis , entails a serious problem , emphasized with immunocompromised patients .', 'The infection of orthopedic implantation devices with Staphylococcus is a serious concern within the biomaterial community .', 'Vascular prosthesis infection is a serious diagnostic and therapeutic problem .', 'Infections of proximal femora with prosthetic implants in situ have long been a major concern in orthopedic surgery', 'Postoperative infections in prosthetic surgery still constitute a serious problem , and one that is difficult to treat , because of the occurrence of agglomerates of microbes that are resistant to immune defenses and antibiotics .', 'Health of human beings is subjected to severe threats from the spread of harmful bacteria and the implant-associated infection remains a serious problem in clinic .', 'Infection of an expanded polytetrafluoroethylene ( ePTFE ) prosthesis after implant is a major drawback of its use in current clinical practice .', 'Acute prosthetic infection is a serious problem .', 'Although infection rates have decreased with the use of antibiotic-coated implants and other enhancements , the risk of infection is still considered a serious concern in penile implant revision surgeries .', 'Bacterial infection of implanted biomaterials is a serious problem that increases health care costs and negatively affects a considerable fraction of orthopedic procedures .', 'For this reason , post implant infection remains a serious concern among plastic surgeons .', 'Local infection near an implant may pose a serious problem for patients .', 'Implant-associated infection is a serious problem in orthopaedic surgery .']


Cluster  631
['A total of 128 patients undergoing EUS were randomized to receive either etomidate or propofol blinded administered by a registered nurse.', 'Etomidate administration resulted in fewer respiratory depression events and had a better sedative efficacy than propofol; however, it was more frequently associated with myoclonus and increased blood pressure during endoscopic procedures.', 'Considering its safety profile, dextromethorphan premedication is an effective approach to facilitate the performance of FB for the physician, and could improve patient comfort.', 'The group that was premedicated with dextromethorphan had lower complaint scores, significantly less coughing, significantly less stress assessed by the patient and the physician evaluation, shorter total procedure time, and fewer midazolam requirements during FB (P-value <0.', 'One hundred twenty patients who were scheduled to undergo diagnostic EGD were randomly assigned to either midazolam plus propofol (MP) or propofol alone groups.', 'A randomized, double-blind, placebo-controlled, prospective study was performed to assess the effect of dextromethorphan premedication on patients who underwent diagnostic bronchoscopy.', 'Of the 55 786 consecutive examinees who underwent EGD, 15 763 asymptomatic examinees who were screened by staff doctors were analyzed.', 'Two patients were deeply sedated after injection of etomidate and unable to answer any questions.']


Cluster  219
['Therefore , how to overcome the difficulty for cool-season turfgrass in spending hot summer successfully , especially in the transitional and warm climatic regions , is a serious problem .', 'Pasture bloat is a serious economic and animal welfare problem in cattle grazed on legumes in New Zealand .', 'On-farm soil frost control has been used for the management of volunteer potatoes ( Solanum tuberosum L. ) , a serious weed problem caused by climate change , in northern Japan .', 'Drought is a serious , worldwide problem for crop production and also affects yields of barley and wheat , together with other stressors such as frost , viral diseases , or fungal pathogens .', 'Drought stress is a serious problem worldwide that reduces crop productivity .', 'However , farmland fragmentation has become a serious problem , causing ecological damage and low crop production efficiency in many parts of the world .', 'In semi-arid areas of China , the ridge-furrow mulched with plastic film ( RF ) cultivation system is a common water-saving agricultural technique where the shortage of water resources has become a serious problem .', 'The potential for increased drought frequency and severity linked to anthropogenic climate change in the semi-arid regions of the southwestern United States ( US ) is a serious concern .', 'Soil compaction is a serious global problem , and is a major cause of inadequate rooting and poor yield in crops around the world .', 'Arid regions pose a serious problem for crop production by suppressing plant growth .', 'Shrub expansion into desert grasslands is a serious problem resulting in loss of forage and rangeland productivity .']


Cluster  1170
['Triiodothyronine was significantly decreased in patients with an unfavorable functional outcome as compared to patients with a favorable functional outcome within 90 d (p = 0.', 'After examining several heart failure treatments and baseline factors, we found that beta blocker treatment results improvement in kidney function.', 'The aim of this study was to determine the diuretic effect of acetazolamide in patients with exacerbations of chronic heart failure, in addition to their stable diuretic therapy.', 'The natriuretic peptide system is an endocrine, autocrine and paracrine system that plays an important role in the maintenance of cardiovascular homeostasis', 'In the UPSTEP (Use of PeptideS in Tailoring hEart failure Project) study we retrospectively evaluated how age and HF duration affected HF outcome.', 'In a double-blind and randomly designed study, 16 patients with heart failure were assigned to two groups: taurine (TG, n = 8) and placebo (PG, n = 8).', 'Low serum triiodothyronine levels can be a predictive marker of short-term outcome after ischemic stroke.', 'Taurine significantly enhanced the physical function and significantly reduced the cardiovascular function parameters following exercise.', 'Former VPI show altered plasma amino acid profiles indicative of a dualistic cardiovascular risk profile (e.g., potentially beneficial elevations in citrulline, arginine, glutamine, and tryptophan, but also raised alanine/lysine ratios, low ornithine and taurine levels) at a preschool age.', 'Twenty-four healthy volunteers were randomized to receive combination of acetyl hexapeptide-3 with tripeptide-10 citrulline (Group G1), tripeptide-10 citrulline (Group, G2), acetyl hexapeptide-3 (Group G3), or neither peptide (Group G4) for 60\xa0days.']


Cluster  1511
['Falls in older adults continues to be a serious problem worldwide .', 'As the world population is growing toward an aging society , elderly fall becomes a serious problem .', 'Accidental fall is a serious problem in older adults .', 'The study was part of an observational cohort survey of elderly fallers which took place in the emergency department of our University urban hospital.', 'Falls in older adults are a serious public health problem associated with irreversible health consequences and responsible for a substantial economic burden on health care systems .', 'Falls are a serious health concern for older people and an important issue for nurses .', 'Falls are a serious public health concern among older adults in the United States .', 'Falls are a serious concern for wheelchair and scooter users with multiple sclerosis ( MS ) .', 'Falls are a serious health problem for older adults .', 'CONTEXT AND OBJECTIVES Falls are a serious public health problem and are one of the biggest reasons for hospitalization , morbidity and mortality among elderly people .', 'Falls in older adults are a serious problem for individuals , their families , and the health care system .', 'Those who work with institutionalized elderly have been much more aware of falls as a serious problem .', 'Fall-related injuries are a serious health problem associated with dependency and disability in the elderly and results in high costs to public health systems .', 'Falls and fall-related injuries are a serious health concern in geriatric populations , especially with age-related deficits in postural control and during postural control challenging dual-task situations .', 'Falls are a serious problem among stroke survivors due to subsequent injuries , recovery setbacks , dependence , and mortality .', 'Falls in the elderly are a serious problem that results in large health care expenditures .', 'Falls are a serious and common problem among older adults .', 'Falls represent a serious problem in older inpatients due to the potential physical , social , psychological and economic consequences .', 'Falls are a serious and preventable problem in older adults .', 'Falling is a serious problem in an aged society such that assessment of the risk of falls for individuals is imperative for the research and practice of falls prevention .', 'Falling is a serious health problem for many elderly .', 'For elderly osteoporotic people falls are a serious problem .', 'Falls are a serious health problem in older adults .', 'Falls among community-dwelling older adults are a serious public health concern .', 'Falls are a serious problem for the elderly and others prone to fall .', 'Falls are a serious problem among older cancer patients .', 'Falls are a serious health concern for older adults .', 'Falls are a serious problem for older adults .', 'Slips and falls are a serious public health concern in older populations .', 'Fall risk is a serious problem especially for the elderly .', 'Falling in older age is a serious and costly problem .', 'Falls are a serious problem facing the elderly .']


Cluster  384
['Soft tissue augmentation with XCM (test) or CTG (control) was performed at 60 implants in 60 patients at the time of implant uncovering.', 'The current study suggests that implants with hydrophilic surface (modified SAE) integrate faster than implants with SAE surface.', 'To describe the peri-implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8-week healing period.', 'However , a major drawback of this approach is that the implant species are limited to the constituents of solid thin films .', 'However , a major drawback of TES products is a lack of skin appendages and nerves to enhance skin healing , structural integrity and skin vitality .', 'A major drawback of implant therapy is the comparatively long healing period involved .', 'A drawback of the implants is that the ridge maintenance depends solely on the physical presence of the hydroxyapatite implants .', 'To investigate the initial clinical and molecular course of osseointegration of different implants in smokers and non-smokers in a randomized controlled trial (RCT).', 'Other factors, such as the type of replaced joint and mechanical stress, seem to be more relevant for implant-related complications.', 'The aim of this randomized clinical trial was to evaluate the implant stability quotient (ISQ) of implants with similar designs, treated with 2 surfaces, sandblasted acid-etched (SAE) and hydrophilic SAE, within the initial 16 weeks of healing.', 'The aim of this study was to evaluate the clinical and radiographic outcomes of regenerative surgical treatment (RST) of peri-implantitis using a bone substitute combined with two different bioresorbable barrier membranes, either collagen membrane (CM) or concentrated growth factor (CGF), during 12-month follow-up.', 'It is particularly important for young patients , in whom complications related with polyethylene damages and metalosis pose a serious clinical problem due to the long period of implant functioning .', 'Lower cellular adhesion and dense fibrous capsule formation around silicone breast implants caused by lower biocompatibility is a serious clinical problem .', 'The aim of this study is comparing the effect of porous titanium granule (PTG) with rotary titanium brush and the use of xenograft and collagen membrane in the treatment of intra-bony peri-implant defects.', 'Characteristics of the implant surface may benefit osseointegration, and the knowledge of this process in diverse clinical situations may play a role in implant dentistry practice.', 'Underlying plaque morphology influenced strut embedment, whereas implantation technique had no direct effect on it.', 'The aim of the present study was to compare the stability of dental implants with different types of surface treatment.', 'Results from 5 to 8 years of follow-up for a large number of subjects confirmed the safety of Natrelle round silicone implants, with no increased risk of systemic disease or suicide versus national norms or saline implants.', 'PTG may be more appropriate for peri-implantitis surgery than xenograft due to inert structure and comfortable use of PTG to provide mechanical support for enlarging the surface area of the implant.', "Peri-implant disease is a serious problem that plagues today 's dentistry , both in terms of therapy and epidemiology ."]


Cluster  1331
['Three component frequencies in the ranges 1.', 'At baseline, all controls had CFF\u202f>\u202f39\u202fHz.', 'The force-frequency relation (FFR) is a hemodynamic index of the chronotropic relationship between left ventricular (LV) systolic function (percent change in dP/dt<sub>max</sub>) and elevation of heart rate.', 'In the older group, the QTVI, low-frequency (LF) power expressed in normalized units, the ratio between LF and high-frequency (HF) power, and systemic peripheral resistances decreased, whereas HF power expressed in normalized units and α HF power increased during the active compared to the sham condition (<i>P</i><0.', 'Daytime low-frequency power (LFP), daytime low frequency/high frequency (LF/HF), nighttime LFP, and nighttime LF/HF and 24-hour systolic blood pressure (SBP) were slightly higher in the frequent PVCs group (p\xa0=\xa00.']


Cluster  183
['Glomerulonephritides (PIGN and crescentic) and obstructive urolithiasis are major causes of pediatric AKI at our center.', 'The occurrence of non-function in one half of a horseshoe kidney resulting from hydronephrosis can , if unrecognized , create a serious surgical as well as medical problem .', 'Nephrotic syndrome ( NS ) is a debilitating renal problem in children resulting from an interaction between environmental and genetic factors including human leukocyte antigen genes ( HLA ) .', 'In patients with autosomal dominant polycystic kidney disease ( ADPKD ) , massive renal enlargement is a serious problem .', "Chronic kidney disease ( CKD ) is still a serious health problem in children with increasing morbidity and affecting children 's quality of life ( QoL ) .", 'Chronic kidney disease in children has an impact on all family members', 'Data on the epidemiology of chronic kidney disease ( CKD ) , which is a serious health problem and refers to a condition related to irreversible kidney damage that further progress to end-stage renal disease in children , are insufficient and data that are available were based on hospital records .', 'Stunted growth is a serious problem for many children with chronic renal insufficiency ( CRI ) .', 'Malnutrition and loss of appetite represent a serious problem in children with chronic renal failure .', 'Clinical conference : a case of polycystic kidney , simulating a severe feeding problem .', 'A severe , chronic and irreversible kidney disease affecting discrete rural populations in the Balkan Peninsula countries , Balkan endemic nephropathy ( BEN ) has been a scientific puzzle for more than half a century .', 'Acute kidney injury in the context of nephrotic syndrome is a serious and alarming clinical problem .']


Cluster  847
['Moreover , a fundamental problem with this approach is that it assumes that the ecosystem is a collection of single species exposed to toxicants under constant conditions ( Cairns , 1982 ) .', 'Its removal from the circulation chain between the natural environment and animals is still a serious problem .', 'A confounding problem with studying the effects of environmental exposure to contaminants in wild populations is that analytical techniques are invasive , particularly where the physiological effects of the toxin are assessed .', 'Seleniferous water continues to be a serious problem to wildlife in the central valley of California .', 'Se water contamination and subsequent accumulation in wildlife is a serious problem in the Central Valley of California , and the subject of increasingly intensive regulatory action .', 'Due to its environmental persistence , it can be detected in ground and water thus becoming the subject of a serious concern because of its potential endocrine disrupting activity .']


Cluster  1454
['Bovine tuberculosis ( bTB ) , caused by Mycobacterium bovis , continues to be a serious economic problem for the British cattle industry .', 'Bovine tuberculosis ( bTB ) , caused by Mycobacterium bovis , is a serious infectious disease that remains an ongoing concern for cattle farming worldwide .', 'Bovine tuberculosis remains a serious problem in several regions , partly due to a lack of specific diagnostic tests .', "Nearly a decade into Defra 's current eradication strategy , bovine tuberculosis ( bTB ) remains a serious animal health problem in England , with c.30,000 cattle slaughtered annually in the fight against this insidious disease ."]


Cluster  1307
['Transforaminal percutaneous endoscopic discectomy (TF-PELD) and interlaminar percutaneous endoscopic discectomy (IL-PELD) are the most common alternative treatments of lumbar disc herniation', 'For lumbar disc herniations patients with annular defects ≥6\u200amm, the ACD was, at 2 years, a highly cost-effective surgical modality compared to conventional lumbar discectomy.', 'The aim of the study determining whether or not Non-invasive Spinal Decompression Therapy (NSDT) was effective in resorption of herniation, increasing disc height in patients with lumbar disc herniation (LHNP).', 'Among patients with large annular defects following limited lumbar discectomy, additional implantation with a bone-anchored ACD lowered the risk of symptomatic reherniation and reoperation over 1 year follow-up.', 'The microsurgical therapy of lumbar disk herniation via a Metrx approach is a safe and effective treatment option and is equivalent to the CM approach.', 'In this randomized multicenter trial, patients with symptomatic lumbar disc herniation and with a large annular defect following limited lumbar discectomy were randomized to bone-anchored ACD or Control groups.', 'While patients with larger disc herniations on average might have a greater likelihood of superior clinical outcomes, the previously suggested "6\xa0mm rule" was not supported.', 'This surgical technique provides good direct decompression and preserves mobility at the treated level, while preventing disc collapse.', 'While patients who achieved substantial clinical benefit (SCB) for MODI had larger disc diameters, this relationship was not found for leg or back pain for any of the measured parameters.', 'To indicate that a minimally invasive technique in which we use interbody fat graft placement showed great results and effectiveness, especially in patients who were suffering from cervical paramedian disc herniation.', 'A total of 96 patients with degenerative lumbar diseases were selected to perform operations between 2008 and 2013.', 'This retrospective review included 63 consecutive adult patients who underwent a single-level, primary lumbar discectomy.', 'Highly migrated intracanal lumbar disk herniations can be sufficiently retrieved using minimal incision, multifidus-sparing MED, which is an effective alternative to conventional microdiskectomy.', 'Twenty-one patients aged 25-65 years undergoing lumbar microdiscectomy were randomly assigned to the rehabilitation group (n= 14) or active control group (n= 7) by simple randomisation.', 'Intervertebral disc degeneration ( IDD ) is a serious health problem worldwide .']


Cluster  1169
['A newly developed microneedle patch was effective and safe for skin brightening and would be a promising functional cosmetic product.', 'A split-face study was designed for efficacy assessment with 34 Korean women applying the tested product (a whitening microneedle patch) on one cheek and a control whitening essence on the other.', 'A provisional phase with soft tissue conditioning does improve the final esthetic result.', 'Men are increasingly seeking out cosmetic procedures, especially minimally and noninvasive body-contouring procedures', 'A double-blind, randomized, placebo-controlled clinical trial was conducted by an independent esthetic clinic on 120 healthy volunteer subjects for 90 days.', 'The escalating urge for a youthful-looking skin instigates continuous innovations with minimally invasive procedures.', 'To test whether or not a fluorescent hybrid zirconia abutment offers superior esthetics compared to a non-fluorescent one-piece zirconia abutment based on spectrophotometric analysis.']


Cluster  316
['( 1 ) Depression is a serious mental health problem particularly in children and adolescents that requires early identification and intervention .', 'Emotional and behavioural are a serious mental health concern among adolescents .', 'In conclusion , mental health disorders in children and adolescents are a serious problem associated with several potentially modifiable factors .', 'Depression is a serious mental health problem , whose first onset is usually in adolescence .', 'Depression in children and adolescents has become a serious public health problem worldwide .', 'Anxiety in adolescence has been a serious problem nowadays . It is seen that anxiety among students cause many harms to their mental and physical health affecting their career .', 'Childhood anxiety presents a serious mental health problem , and it is one of the most common forms of psychological distress reported by youth worldwide .', 'Depression in adolescents is a serious problem to society because of the high prevalence rate , the high subjective burden of illness and negative ( economic ) consequences .', 'Depression is a serious mental health problem and is common in children and adolescents .', 'Childhood and adolescent mental health problems are a serious and growing concern worldwide .', 'High prevalence rates of psychiatric morbidity have been documented among adolescents within youth correctional institutions in Nigeria']


Cluster  862
['The formalism does not impose constraints on how the relations between phrases and strings are defined , and the grammar writer has to define them explicitly . they work better on few articles which were highly modified by editors', 'Our solution to the problem of lone prepositions', 'Comment type 2 has only 2 variations as . need of extensive syntactic resources to determine the knowledge to be acquired', 'A more regrettable shortcoming is the fact that the book is not multilingual in scope', 'In the area of automatic essay scoring , essay content are represented to facilitate the scoring . lone prepositions', 'Both of these previous works have the shortcoming of downgrading explicit relations to implicit ones by removing the explicit discourse connectives', 'This paper has been supported by Ministerio de Ciencia e Innovaci -- n - Spanish Government -LRB- grant no . we are confronted , again , with a syntactic feature containing , among other things , records of derivation history', 'Continuing to focus on the materialised KB2 , we note another limitation of existing works : if only existential quantifiers are used then some objects are unidentifiable ( i.e. , it is not possible to distinguish them uniquely )', 'However , sometimes combinations of features or feature values may be very good predictors . manual linguistic mark-up is not based on abstract rules but rather on individual linguistic intuition', 'Secondly , once a specific analysis is determined , the process of splitting off or abstracting off a feature must be clear on what the form of the resulting word should be . the bound is loose in many cases', 'The main ideas of the three-level semantics can be stated as follows : they make little or no direct use of syntactic information', 'The only drawback is , that we are confronted , again , with a syntactic feature containing , among other things , records of derivation history', 'The disadvantage of this slow , gentle approach is that even by the end of the book , neither Prolog nor parsing has been covered in depth', 'A drawback of their method is , however , that manual linguistic mark-up is not based on abstract rules but rather on individual linguistic intuition']


Cluster  1623
['We believe that immunosuppression-induced pneumonitis in a lung allograft is a serious dilemma for lung transplant physicians', 'Infection of thoracic synthetic grafts is a serious problem , potentially leading to septicemia .', 'Despite significant advances in organ preservation , surgical techniques and perioperative care , primary graft dysfunction is a serious medical problem in transplantation medicine in general and a specific problem in patients undergoing lung transplantation .', 'Infections remain a serious and common problem in lung transplant recipients .', 'In lung transplantation , reimplantation response is still a serious problem .', 'It has been advocated that a major drawback of single lung transplantation ( SLT ) is the risk of serious complications arising from the native lung .']


Cluster  1913
['Faculty attrition , particularly among female and minority faculty , is a serious problem in academic medical settings .', 'Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal', 'Insecurity in medical education : a preventable problem ?', 'Medical educators perceive grade inflation to be a serious problem .', 'Medical student impairment is recognized as a serious problem .', 'Attrition from medical school remains a serious cause of concern for the medical education community .']


Cluster  789
['Anorexia nervosa , bulimia nervosa , binge-eating disorder are characterized by a serious disturbance in eating , such as restriction of intake or bingeing , as well as distress or excessive concern about body shape or body weight .', 'Feeding and eating disorders represent a serious problem especially in young population .', 'Underweight eating disorders (EDs) are notoriously difficult to treat, although a growing evidence base suggests that outpatient cognitive behaviour therapy for EDs (CBT-ED) can be effective for a large proportion of individuals.', 'Subsequently , eating disorders have become a serious concern for medical and dental professionals .', 'Drop-out from treatment is a serious problem in eating disorders which remains poorly understood .', 'Previous research suggests that computerized interpretation bias modification (IBM) techniques may be useful for modifying thoughts and behaviours relevant to eating pathology; however, little is known about the utility of IBM for decreasing specific eating disorder (ED) symptoms (e.g. bulimia, drive for thinness).', 'The strong response indicates that eating disorders are a serious concern in primary practice .', 'Eating disorders : A serious problem of mental health seeks solution .', 'A serious problem faced by clinicians treating anorexia nervosa is the egosyntonic nature of the illness , wherein individuals with anorexia nervosa value their disorder , thereby hindering motivation for recovery and engagement with treatment .', 'The current study examined whether variations in patient weight and eating-disorder behavior frequency influenced the recognition of bulimia nervosa ( BN ) and the perception that it is a serious mental health concern .', 'We argue that , because there is scant research into men with eating disorders and men strive to conceal this health problem , nurses should be equipped with information that will support earlier detection of EDs among men and boys before they manifest as a serious health problem .', 'The current study suggests that cognitive interventions for individuals with primary BDD symptoms may improve co-occurring ED symptoms such as bulimia.', 'The findings, which were comparable to the previous Australian effectiveness study of CBT-E, indicate that CBT-E is an effective treatment for adults with all eating disorders within out-patient settings.']


Cluster  1530
['This may make them less susceptible to the subtleties of style manipulation than would be the case if they were free of other tasks . noisy proliferation', 'This may make them less susceptible to the subtleties of style manipulation than would be the case if they were free of other tasks . noisy proliferation', 'This may make them less susceptible to the subtleties of style manipulation than would be the case if they were free of other tasks . noisy proliferation']


Cluster  2236
['Even though it is diminishing in Europe , smoking is still a serious health problem .', 'Smoking is a serious public health problem and an important risk factor of many diseases .', 'Smoking is a serious worldwide public health problem .', 'The smoking represents a serious problem of public health .', 'Despite decades of public education , cigarette smoking remains a serious health problem .', 'Smoking is a serious global public health concern that has been related to many chronic diseases .', 'Smoking is still a serious economic , health , and social problem despite various efforts to curb its prevalence .', 'Smoking is a serious public health problem .', 'Smoking is a serious public health problem worldwide .', 'Smoking is a serious public health concern , particularly among young people .', 'Smoking is a serious problem for the health care system .', 'Despite smoking cessation efforts , cigarette smoking remains a serious general and oral health problem .']


Cluster  26
['As a result of contaminated water and poor hygiene , related infections are still a serious problem .', 'The microbial contamination of water miscible metalworking fluids ( MWFs ) is a serious problem in metal industry .', 'Contamination of water by fecal matter and potential human enteric pathogens is a serious health concern .', 'Pollution in industrial areas is a serious environmental concern , and interest in bacterial resistance to heavy metals is of practical significance .', 'Exposure to waterborne pathogens in recreational or drinking water is a serious public health concern .', 'Wastewater irrigation in the Middle East , one of the most water-stressed regions in the world , could be a key factor for socio-economic development , but the microbial contamination of untreated or partially treated wastewater is a serious public health concern .', 'Fecal pollution of water is a serious concern because it is associated with the transmission of pathogens .', 'Bacterial contamination at any of these steps remains to be a serious public health concern .', 'Contamination of tap water by Methylobacterium species has become a serious concern in hospitals .', 'Exposure to pathogens in recreational or drinking water is a serious public health concern .', 'Pathogen contamination of the public drinking water supply in the New York City watersheds is a serious concern .', 'Because of heavy dependence on groundwater for drinking water and other domestic use , microbial contamination of groundwater is a serious problem in the Kathmandu Valley , Nepal .']


Cluster  2355
['The aim of the study was to assess whether in geriatric patients, the shear bond strength (SBS) of glass-ceramics differed when compared to young controls.', 'In geriatric patients, the shear bond strength of glass-ceramics did not differ when compared to that of young controls.']


Cluster  991
['One problem with discriminant analysis of DNA microarray data is that each sample is represented by quite a large number of genes , and many of them are irrelevant , insignificant or redundant to the discriminant problem at hand .', 'A drawback of the Amplified Fragment Length Polymorphism ( AFLP ) fingerprinting method is the difficulty to correlate the different fragments with their DNA sequence .', 'A potential problem with microarray research is that sequence similarity between and within these families of closely related genes may lead to cross-hybridization .', 'Presence of two versions of a DNA sequence based on the two progenitor genomes poses a serious technical and analytical problem during single nucleotide polymorphism ( SNP ) marker identification and analysis .', 'Naively classifying natural hybrids into the standard six line cross categories can be misleading , and false classification can be a serious problem for datasets with few molecular markers .', 'A major problem with greenbeard-based models is that greenbeard recognition systems are uncommon among animals , which tend to learn kin phenotypes .', 'Another problem with genomic analyses is that it is difficult to identify functionally similar yet non-homologous molecules such as different families of cysteine-rich neurotrophic factors in different phyla .', 'The most suitable method for this issue is likelihood ratio test using logistic regressions , which we call interaction test , but a serious problem of this test is computational intractability at a genome-wide level .', 'One problem with RBH is that it will incorrectly predict a paralog as an ortholog when incomplete genome sequences or gene loss is involved .', 'A potential drawback of this approach is that the human-designated functional classes may not accurately reflect the underlying biology , and consequently important sequence-to-function relationships may be missed .', 'A drawback of the current practice of solely discriminating slow , intermediate and rapid genotypes for phenotype inference is limited resolution of differences between slow acetylators .', 'Determining sister chromatid exchanges may also be a viable test , but it has the drawback of uncertainty as to whether the changes are attributable to present or past exposure .', 'Orthologs inference is the starting point of most comparative genomics studies, and a plethora of methods have been designed in the last decade to address this challenging task']


Cluster  2076
['This retrospective observational study suggested that CRRT with AN69ST membrane might be associated with better in-hospital outcomes.', 'Of 2,469 ICU patients, 156 were treated by AN69ST membrane.', 'Polyethylenimine-coated polyacrylonitrile (AN69ST) membrane is expected to improve the outcomes of critically ill patients treated by continuous renal replacement therapy (CRRT).']


Cluster  1658
['Many children are treated for recurrent acute otitis media and middle ear effusion with ventilation tubes (VT).', 'Hypertrophic adenoids with otitis media with effusion is a common infectious disease and present a serious otological problem in children .', 'Chronic suppurative otitis media ( CSOM ) is an important cause of hearing loss in children and constitutes a serious health problem globally with a strong association to resource-limited living conditions .', '[ Intracranial otogenic complications : inspite of therapeutic progress still a serious problem ] .', 'Unresolved otitis media ; a serious new problem .', 'The otorrhea forms a serious problem in 30 % of the VT that show drainage ; it is more frequent in younger children and in those with a history of recurrent otitis media , especially if they were associated with otorrhea .', 'Acute otitis media ( AOM ) is a serious public health problem and is considered one of the most common diagnoses in pediatric outpatient units .', 'Serous otitis media : a serious problem .', 'Non-tuberculous otomastoiditis is a severe ear disease with challenging considerations , and should be treated aggressively in order to avoid morbidity .']


Cluster  133
['Psychiatric symptoms and disorders are a serious problem area , absorbing high health service provision capacities .', 'Homelessness is a serious problem among patients with severe mental illness .', 'A serious and chronic problem that confronts mentally ill people and mental health professionals is the inability of society to provide the requisite resources for adequate care-giving systems .', 'Psychiatric disorders are a serious public health problem , especially as many psychiatric disorders begin early in life .', 'However , unlike developed countries which are endowed with many and relatively well-paid mental health specialists , low-income countries face a dire shortage of highly trained mental health professionals in addition to several other challenges .', 'The Ugandan government recognizes mental health as a serious public health and development concern , and', 'Therefore , more than 10 % currently had either a psychiatric or a severe cognitive problem .', '178 college students searched telephone directories with instruction to find help for a friend with a serious emotional problem .', 'The survey examined their use of homework for individuals diagnosed with a severe mental health problem .', 'Mental health treatment dropout is a serious problem , especially among patients who have low income , are young , lack insurance , are offered only single-modality treatments , and have negative attitudes about mental health care .', 'Common mental disorders ( CMD ) represent a serious , growing public health concern , especially in women .', 'Mental disorders are a severe health problem , and the number of patients is growing worldwide .', 'Mental Disorders constitute a severe Public Health problem in developing countries due to inadequate resources specially in terms of trained personnel ; furthermore , Mental Health care is given out only in specialized Institutions where it has not been possible to provide coverage for more than a small part of the population .', 'Families living with a person with mental illness can experience distress requiring therapeutic interventions.', 'Lack of access to support , services , and providers for children and adolescents with mental health conditions is a serious problem in the United States .', 'Mental illness stigma is a serious societal problem and a critical impediment to treatment seeking for mentally ill people .', 'The problem with the provision of such support is that the stigma of mental disorder causes many individuals to avoid seeking help .', 'The author foresees that the Government will face a serious problem in future to cater for the increasing number of chronic schizophrenic patients in the community if it does not take immediate action to improve mental health services in the country .', 'Together , these studies suggest that traditional methods of teaching psychopathology do not lessen mental illness stigma , a serious concern that can potentially be reconciled by incorporating more person-centered instructional methods .', 'The prevalence of mental health difficulties in Northern Ireland (NI) is significantly higher than in England.', 'Investigating variables associated with mental health literacy in the college-age population takes us one step closer to providing intervention for this vulnerable group , where growing rates of psychological disorders are a serious public concern .']


Cluster  2108
['There was no significant difference between the normal saline and lidocaine group for mean arterial blood pressure, heart rate, and bispectral index at any time point (P>0.', 'There was no significant difference in length of intensive care unit stay (2.', 'From the 709 patients recruited, 702 were studied in this 6-months period with no statistical differences in the baseline variables studied.', 'There was no significant difference in age, gender, body mass index, the American society of anesthesiologists score, comorbidity, or underlying disease between the lidocaine patch and control groups.', 'The baseline characteristics did not differ between ivabradine and placebo groups (mean age was 59.', 'Baseline patient characteristics were not significantly different between the groups.', 'The CHAMPION trial excluded patients previously treated with biologics, and the M10-255 trial had no restrictions.', 'No differences in 1-attempt success rate was found between nurses and paramedics (27/34 [79.', 'No difference was found regarding the duration of blood sampling between the two groups, even after stratifying the patients into the three age subgroups.', 'No difference was found for duration of hospitalization (median 7.', 'We found no difference in our primary outcome parameter of time to first rescue analgesic.', 'The long-term outcomes of TIA patients did not differ according to the definitions applied.']


Cluster  2273
['The prevalence of morbidity and mortality from drug resistant malaria ( Plasmodium falciparum ) is increasing in most of the developing countries , which is also a global threat because international travel is common now and imported malaria is increasingly a serious problem .', 'Malaria is an infectious disease gradually becoming a serious concern for public health institutions , even in European countries where the eradication of the disease was previously taken for granted .', 'Malaria , a devastating infectious parasitic disease , has been recognized by the World Health organization ( WHO ) as a major public health problem worldwide .', 'Malaria is a serious disease and still remains a public health problem in many parts of Nigeria .', 'Malaria is a serious health concern in Africa .', 'Malaria is a serious health problem in Malawi .', 'Malaria disease remains a serious worldwide health problem .', 'Malaria remains a serious public health problem globally .', 'Malaria is a serious health problem in developing countries .', 'Malaria remains a severe health problem in Sub-Saharan Africa , with approximately one million deaths and 365 million cases each year .', 'Malaria remains a serious public health problem with significant morbidity and mortality .', 'Malaria represents a serious public health problem , presenting with high rates of incidence , morbidity and mortality in tropical and subtropical regions of the world .', 'Malaria is and remains a serious health concern in Africa .', 'Malaria is a life-threatening health problem worldwide and treatment remains a major challenge .', 'Infection by the parasite of malaria is a serious healthcare problem for populations residing primarily in tropical and subtropical countries .', 'Malaria remains a serious problem in global public health , particularly widespread in South America and in tropical regions of Africa and Asia .', 'Human malaria , which is caused by infection with Plasmodium , is a serious global public health problem .', 'Malaria remains a serious health problem in many parts of the world .', 'Malaria is still a serious public health problem on Bioko Island ( Equatorial Guinea ) , although the number of annual cases has been greatly reduced since 2004 through the Bioko Island Malaria Control Project ( BIMCP ) .', 'The malaria caused by Plasmodium falciparum remains a serious public health problem in the world , due largely to the absence of an effective vaccine .', 'Malaria , particularly that one caused by Plasmodium falciparum , remains a serious health problem in Africa , South America , and many parts of Asia where it afflicts about 500 million people and is responsible for the death of more than one million children each year .', 'Malaria is a life-threatening infectious disease , affecting over 250 million individuals worldwide each year , eradicating malaria has been one of the greatest challenges to public health for a century .', 'It is recognized as a serious problem in Plasmodium falciparum-endemic sub-Saharan Africa , where recent data suggests that it is more common than previously believed .', 'Malaria is still a serious public health problem in some parts of the world .', 'The number of malaria cases is declining worldwide ; however , it remains as a serious health problem .', 'Malaria is a serious public health problem at present ; it affects almost half of the population from over 100 countries and poses a high risk of reintroduction in Cuba .', 'Malaria is a life-threatening disease of global concern .', 'Drug resistance in Plasmodium falciparum is a serious problem in most endemic areas .']


Cluster  639
['Myotonic dystrophy , a rare genetic disorder , may pose a serious problem to the anaesthesiologist due to muscular and extramuscular involvement .', 'The present study identified the clinical characteristics and outcomes of patients with myxedema coma using a large-scale database.', 'Sudden death is a serious problem in patients with myotonic dystrophy .', 'We conducted a retrospective observational study of patients diagnosed with myxedema coma from July 2010 through March 2013 using a national inpatient database in Japan.']


Cluster  266
['GOALS AND WORK : Despite medical awareness , intractable pain is a serious problem in cancer and occurs in up to 2 % of advanced cancer patients .', 'Persistent pain is a serious problem that often contributes to a poor quality of life in pancreatic cancer patients .', 'Under-diagnosis of pain is a serious problem in cancer care .', 'In patients with advanced cancer , cancer-induced bone pain ( CIBP ) is a severe and common problem that is difficult to manage and explain .', 'Especially , pain secondary to bone metastases is a serious problem in many patients with metastatic cancer .', 'Chemotherapy-induced neuropathy is a serious clinical problem for patients receiving cancer treatment .', 'Pain is a serious and common problem in bone metastases .', 'Bone cancer pain ( BCP ) remains a serious complication of malignancy , which is an intractable clinical problem due to the gap in knowledge of its underlying mechanisms .', 'Despite numerous guidelines, nearly one of two patients with cancer pain remains undertreated, thereby affecting their quality of life.', 'The management of breakthrough pain (BTP) in cancer patients is a challenge.', 'Breakthrough pain (BTP) arising due to rib metastasis is very distressing and often very difficult to manage by titration of traditional analgesics', 'Most cancer patients are treated with chemotherapy , and peripheral neuropathy is a serious and common clinical problem affecting patients undergoing cancer treatment .', 'Bone metastases are a severe problem in oncology , since they usually are associated with pain .']


Cluster  1854
['S100-levels <123 pg mL-1 measured on PD1 reliably rule out the development of POD after elective OPCAB-surgery.', 'TRX in postoperative serum may be a potential biomarker to predict POD and POCD in elder patients undergoing hip fracture surgery.', 'In this prospective, observatory study, TRX concentrations in preoperative and postoperative serum from 192 patients and serum from 192 controls were measured using an enzyme-linked immunosorbent assay.', 'In the nicardipine group, Ccr at POD1 was increased compared with that after surgery.']


Cluster  771
['A retrospective study was performed in order to compare the surgical profile of risk factors and perioperative complications for laminectomy and laminectomy with fusion procedures in the treatment of spinal epidural abscess (SEA).', 'We conclude that posterolateral lumbosacral fusion with transpedicular fixation provides a satisfactory clinical outcome in patients with spondylolysis-olisthesis , but the high incidence of complications related to the fixation device in the other indications studied is a serious drawback of the method .', 'These findings show a relation between bone turnover and nonunion after spinal fusion surgery.', 'Precept Modular seems to be the most useful system when performing hybrid technique in lumbar fusion procedures.', 'Both laminectomy and laminectomy with fusion effectively treat SEA, but addition of fusion is associated with significantly higher rates of transfusion and perioperative return to the operating room.', 'Epidural fibrosis following a laminectomy procedure is a serious problem that results in failed back surgery syndrome .', 'To compare radiation exposure between ultra-low radiation imaging (ULRI) with image enhancement and standard-dose fluoroscopy for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).', 'Single-center, prospective, randomized, and single-blinded clinical trial was conducted in patients (n=64) undergoing anterior or posterior spinal interbody fusion.']


Cluster  1540
['SOX10 immunohistochemistry may be of utility in distinguishing some of the varying adnexal tumors from each other, and from basal cell carcinoma (BCC), but given the staining of both apocrine and eccrine tumors, does not seem to provide information as to their origins as either eccrine or apocrine tumors.', 'A mouse monoclonal anti-SOX10 (clone BC34: Biocare Medical; Concord, California) immunohistochemical antibody was performed on various sweat gland tumors and basal cell carcinoma.', 'SOX10 showed positivity in spiradenomas (13/13), cylindromas (9/10), hidradenoma papilliferum (10/10), syringocystadenoma papilliferum (8/10), apocrine adenomas (8/10), and negativity in poromas (0/12), syringomas (0/10), and basal cell carcinomas (0/13).', 'SOX10 is a newer Schwannian and melanocytic marker that has generated great interest for its relative sensitivity and specificity in the diagnosis of neural crest-derived tumors.']


Cluster  357
['A total of 105 patients with HCC, 91 with liver cirrhosis, 102 with chronic hepatitis, and 100 healthy subjects were recruited.', 'Chronic hepatitis C virus infection represents a serious global public health problem , typically resulting in fibrosis , cirrhosis , and ultimately hepatocellular carcinoma .', 'Chronic hepatitis C ( CHC ) is a serious medical problem necessitating more effective treatment .', 'Hepatocellular carcinoma ( HCC ) developing after hepatitis C virus ( HCV ) eradication is a serious clinical concern .', 'Chronic hepatitis C ( CHC ) is a serious clinical problem .', 'Hepatitis C virus ( HCV ) infections are a serious viral health problem globally , causing liver cirrhosis and inflammation that can develop to hepatocellular carcinoma and death .', 'The development of hepatocellular carcinoma ( HCC ) after a sustained virologic response ( SVR ) due to interferon ( IFN ) therapy for hepatitis C virus infection remains a serious problem .', 'Hepatitis C virus (HCV)-mediated chronic liver disease is a serious health problem around the world and often causes fibrosis/cirrhosis and hepatocellular carcinoma .', 'Hepatitis C is a serious public health problem throughout the world ; chronic renal patients are highly exposed to this infection .', 'Chronic hepatitis C is a serious global medical problem necessitating effective treatment .', 'Abstract Hepatitis C virus ( HCV ) infection is a serious health problem worldwide that can lead to hepatocellular carcinoma or end-stage liver disease .', 'Hepatitis C virus ( HCV ) infection is a serious health problem leading to cirrhosis , liver failure and hepatocellular carcinoma .', 'Tested group consist of 160 patients with chronic hepatitis.', 'Chronic hepatitis is a serious problem because the disease seems to be progressive despite prednisone therapy .']


Cluster  964
['But the problem with this approach is that the uncertainty of complaint delay time has a great impact on the identification accuracy .', 'Although advantageous for the quality and efficiency of RE modelling , the huge number of point datas can turn into a serious practical problem , later on , when the CAD model is generated .', 'A potential drawback of this model is that the HDE is in limited supply and preparation of new HDE will not contain the exact components of the HDE used to define our model system .', 'The major problem to overcome with such a system , however , is that of insufficient data for reconstruction .', 'The other difficulty is caused by limited data', 'An important problem with the data is that results may be unphased with respect to their identification data for mechanical reasons .', 'A further issue faced by these models is that the resources they rely on require significant effort to create and will not always be available to model data in a new language or a new domain', 'A problem with this approach , however , is that such elucidation remains difficult .']


Cluster  2318
['All three modalities detected a reduction in gastrointestinal motility following xylazine administration with AUC ROC being 0.', 'Assessment through Digestive Symptom Frequency Questionnaire 5 point Likert scale showed significant improvement in interventional arm compared to placebo on symptoms such as bloating/cramping, abdominal pain, diarrhea, constipation, stomach rumbling, nausea, vomiting, headache, and anxiety.', 'Gastrointestinal motility disorders often pose a debilitating problem , especially in elderly patients .', 'Impairment of gastrointestinal (GI) motility is an undesirable but inevitable consequence of surgery.', 'This study suggested that GFD may be effective in controlling gastrointestinal symptoms and ASD behaviors.', 'GI intolerance is a common preclinical finding and can be a serious clinical safety concern .', 'These two cases suggest that dehydration and electrolyte disturbance from high stomal output could be a serious problem following chemoradiation therapy in patients with an ileostomy .', 'Dyspeptic symptoms present a severe problem in gastrointestinal ( GI ) cancer patients .']


Cluster  1047
['A cross-sectional study was conducted among 194 sexually active partnered CC survivors aged 25 to 69\xa0years.', 'Linear mixed model analyses showed significant treatment effects for psychosexual knowledge and adequate insight in boundaries, both posttreatment and at follow-up.', 'Sexual activity is an integral part of life; it is important to address sexual health after stroke, but this is often poorly done.', 'Just less than one third of participants ( n \xa0 = 61 , 30.3 % ) reported that sex had changed for the worse since their cardiac event or diagnosis , with approximately half of these stating that this was a serious problem for them .', 'Provision of written information alone appears to be as effective as a 30-min individualized sexual rehabilitation programme in an inpatient setting.', 'Appropriate rehabilitation programs should be developed for CC survivors to prevent and reduce not only vaginal sexual symptoms but also sexual pain worry, relationship dissatisfaction, and body image concerns to reduce sexual distress.', 'To assess the effectiveness of a structured sexual rehabilitation programme compared with written information alone regarding sexual and psychological functioning (anxiety, depression, stress), functional independence and quality of life in an Australian stroke cohort.']


Cluster  1161
['Leprosy still represents a serious health problem in a number of countries , including Brazil .', 'Leprosy is a chronic disease , caused by Mycobacterium leprae , which poses a serious public health problem worldwide .', 'Leprosy is a serious public health problem in peripheral and developing countries .', 'This paper discusses the issue of defaulters with paucibacillary leprosy and the findings of the study suggest that defaulters with paucibacillary leprosy are not a serious problem in terms of leprosy control .', 'Plantar ulcers present a serious problem in the management of leprosy .', 'Despite achieving the goal of national elimination of leprosy , it remains a serious public health problem in the high prevalence states of Uttar Pradesh , Bihar and Orissa .', 'The present results also show that relapse of leprosy is acceptably low and has not yet become a serious clinical or public health problem but , based upon the incubation of relapse in MDT patients , it is necessary to encourage annual follow up for at least 5 years for paucibacillary ( PB ) and 10 years for MB patients after being released from WHO/MDT .', 'Leprosy , a chronic infectious disease , poses a serious public health concern due to its impact on the wellbeing of affected people .', 'Leprosy is one of the oldest diseases of humanity and persists as a serious public health problem .', 'Lagophthalmos continues to be a serious problem in cured leprosy patients .', 'Although multidrug therapy is considered an effective treatment for leprosy , antimicrobial resistance is a serious concern .', 'A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals.', 'due to late diagnosis and higher frequency of treatment abandonment leprosy is a serious public health problem among children and adolescents', 'PEOPLE is a cluster-randomized trial with villages selected on previous leprosy-incidence and randomly allocated to four arms.', 'During the 19th century leprosy was a serious health problem in Norway , especially in some western , rural districts .']


Cluster  997
['The students who had experienced urinary loss rated the problem with a 2.3 average score ( ranging form 0 to 6 ) , with 0 being no problem and 10 being a serious problem .', 'An LD of 10.', 'Thirty-one samples (22%) were <i>H.', 'At baseline, Vaizey incontinence score was 16.', 'The mean baseline Expanded Disability Status Scale score was 4.', 'The mean ± SD Foot Posture Index scores ranged from 5.', 'The mean FES-I score at baseline was 42.']


Cluster  1739
['In addition to no difference in diagnostic yield, the 19-G needle yielded samples that were frequently less adequate and more often bloody compared with the 22-G needle.', 'A randomized controlled study was conducted in a single academic center on patients who underwent sampling with fork-tip or side-fenestrated 22-gauge or 25-gauge needles.', 'Both needles showed equivalent safety and diagnostic accuracy.', 'Twenty-five patients underwent standard needle and 27 RF TS access.', 'Our objectives were to assess for differences between standard and radiofrequency (RF) needle in procedural times, success, and spatial accuracy.']


Cluster  2115
['Obesity is a serious medical problem worldwide and disruption of metabolic/energy homeostasis plays a pivotal role in this global epidemic .', 'As obesity is a serious health problem which promotes metabolic abnormalities ( insulin resistance , hyperinsulinemia and dyslipidemia ) and dramatically increases the risk for CVD , this review will focus on the epidemiologic and genetic background of obesity .', 'Obesity resulting from interactions of genetic and environmental factors becomes a serious public health problem worldwide with alterations of the metabolic phenotypes in multiple biological matrices involving multiple metabolic pathways .', 'Obesity is a serious health problem worldwide and many genes have been implicated in determination of obesity , but our knowledge of the genes responsible for individual differences in weight loss after physical intervention are poor .', 'Since obesity is a serious problem as a civilization-related disease , it is very important to investigate genes suspected to be connected with it .', 'Obesity is a serious problem that has been linked with CVD and diabetes via a variety of adipokines .', 'Although obesity is considered a severe problem , very little is known about the molecular mechanisms causing the associated degeneration of organs and finally death .']


Cluster  854
['Training and querying this model for all German documents can be done in several hours . the neglect of document structure', 'The document was quite long for the PAHO set , containing about 1400 lines of text and 360 alignment blocks in the English document and 1000 lines and 297 blocks in the Spanish text . the sequential models treat queries as unstructured ( linear ) sequences of words', 'A limitation of the primitive weighting function described in Equation 1 is that it can not bridge vocabulary gaps between documents and queries', 'This multi-lingual query builder is an effective tool to improve the quality of PubMed queries in particular for researchers whose first language is not English.', 'Twenty residents used the French version of the query builder and 22 used the English version.', 'The document was quite long for the PAHO set , containing about 1400 lines of text and 360 alignment blocks in the English document and 1000 lines and 297 blocks in the Spanish text . the sequential models treat queries as unstructured ( linear ) sequences of words', 'We designate a query as bilingual if the concept has been searched by users of both two languages . these models are restricted to reorderings with no gaps and phrases that are adjacent', 'One model for this problem begins with a list of intervals , each with an associated score ; each interval gives the range of positions in the query sequence that align to a database sequence , and the score is that of the alignment .']


Cluster  1330
['One problem associated with the existing method is that it produces a wide range of initial pin forces despite a constant applied torque .', 'One problem with such methods is that they tap only a few points on the flat sole under the foot and , therefore , do not account for the total ground reaction force .', 'Smart devices are capable of accurately reflecting many of the spatiotemporal gait metrics of inertial sensors.', 'A drawback of using accelerometers is the poor quality of inclination estimate for movements with large accelerations .', 'The influence of back reflection resulted in a serious problem in measurement accuracy of the apparent changes of measured velocities .']


Cluster  580
['An epidemic of tremor disease of Chinese mitten crabs , Eriocheir sinensis , has become a serious problem in recent years .', 'While fishers perceive a serious negative impact of fishing activities on sea turtles in the San Ignacio-Navachiste-Macapule area , they do not see themselves individually as part of the problem .', 'As oysters are eaten raw in Japan , their contamination with the non-bacterial agent of gastroenteritis has become a serious health problem .', 'It is suggested that THV infection is not a serious problem for the Chinese soft-shelled turtle culture in this region .', 'An infection of pearl oysters , Pinctada maxima , attributed to a Haplosporidium sp. by Hine and Thorne ( 1998 ) has been detected on 3 occasions and is considered to represent a serious concern to the pearling industry in Australia .', 'Recent outbreaks of AHPND in Asia have been causing great losses for shrimp culture and have become a serious socioeconomic problem .', 'Oysters are widely consumed seafood , but their shells impose a serious environmental problem .']


Cluster  2060
['This creates a serious problem requiring close study if a solution is to be found and if one of the most effective weapons for plague-control is not to be rendered useless .', 'Outbreaks of the illness take place with a mortality rate of 10 % , and the potential terrorist use of the toxin has become a serious concern .', 'The coronavirus outbreak emerged as a severe pandemic , claiming more than 0.8 million lives across the world and raised a major global health concern .', 'Plague is a deadly disease of obvious concern to individuals , communities , and public health officials .', 'Monsoon epidemics are always a serious concern in the public health sector .', "Pandemics constitute a serious problem to global health with a major impact on the affected countries ' populations .", 'This represents a serious public health concern in the Arabian peninsula .', 'Syrian ( and Middle East ) health and economy sectors are still affected by this disease causing a serious national problem that needs to be solved .', 'Global pandemics are a serious concern for developing countries , perhaps particularly when the same pandemic also affects donors of development aid .', 'Plague is still a serious public health problem in Asia .']


Cluster  2211
['To assess the safety and efficacy of fascial therapy treatment in patients with hemophilic arthropathy of ankle and knee.', 'Atrophic nonunion of the distal humerus in children with osteogenesis imperfecta is a vexing and disabling problem .', 'Patients suffering from well-defined rheumatoid forefoot deformity were prospectively enrolled in three institutions.', 'Rheumatoid arthritis of the foot and ankle can be a debilitating problem , particularly for patients who have undergone successful hip or knee arthroplasty .', 'The instability of the upper and the lower ankle joint represents a serious problem in patients with fibular aplasia .', 'Pyogenic arthritis of the hip in neonates remains a serious problem .']


Cluster  1015
['Binge drinking is a serious problem among adolescents and young adults despite its adverse consequences on the brain and behavior .', 'Underage alcohol drinking is a severe public health problem .', 'Binge drinking in adolescents is a serious problem that has been recognised for over a generation .', 'Binge alcohol drinking during adolescence is a serious health problem that may increase future risk of an alcohol use disorder .', 'The aim of this study was to validate five scales, based on a theoretical framework for the adoption of behaviours, designed to assess the determinants in binge drinking in adolescents, namely: attitude, social influence (model, norm and pressure) and self-efficacy.', 'Adolescent alcohol use is a serious public health concern .', 'Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment .', 'Alcohol consumption is a serious problem among adolescents in Thailand and is strongly associated with various health-risk behaviors .', 'Although the minimum drinking age in all 50 U. S. states is 21 years of age , drinking among underage persons ( ages 12 - 20 ) remains a serious public health concern .', 'Underage drinking is a serious societal concern , yet relatively little is known about child sipping of alcohol and its relation to beliefs about alcohol .', 'Adolescent alcohol drinking , primarily in the form of binge-drinking episodes , is a serious public health concern .', 'Five scales are presented with indications of reliability and validity, their items reflect the theoretical frame of reference and can evaluate the determinants of binge drinking.', 'Adolescent alcohol abuse remains a serious public health concern , with nearly a third of high school seniors reporting heavy drinking in the previous month .', 'Alcohol abuse and dependence in adolescents is a serious health concern with significant morbidity and mortality .', 'Binge drinking is a serious problem among adults and youths that can be reduced by implementation of evidence-based interventions .', 'Early-onset drinking during childhood or preadolescence is a serious social problem .', 'The average age of young people with alcohol intoxication has increased and parents have become stricter , but binge-drinking is still a serious problem .', 'Underage drinking is a serious public health problem in the United States , and youth exposure to alcohol advertising has been indicated as a possible contributing factor .', 'Alcohol consumption among adolescents is a serious public health concern .', 'Excessive alcohol use is a serious public health concern worldwide , but less attention has been given to the prevalence , risk and protective factors , and consequences of early alcohol use in low-income , developing countries .', 'Binge drinking of alcohol during adolescence is a serious public health concern with long-term consequences , including increased pain , fear , and anxiety .', 'Because underage drinking is a serious public health concern and associated with numerous detrimental consequences , many interventions to prevent underage drinking have been developed .', 'Binge alcohol drinking among adolescents has been a serious public health problem .']


Cluster  405
['Hydrocortisone treatment did not alter trypsinogen release (2 or more positive days 46% vs 50%), but it significantly reduced overall complications compared with placebo in the high-risk patients (18% vs 41%; P < 0.', 'In such systems , a trace amount of HACs in the dietary pellets may interfere with the test results and thus can be a serious problem for the low-dose issue , which is now a major topic in the field of endocrine disruptor research .', 'Elevated serum VN levels represented high diagnostic value and had close relation to clinicopathological factors and early recurrence, suggesting that serum VN might be a useful diagnostic and prognostic marker for HCC.', "False-negative test results in hypercortisolism could occur when [cortisol] is outside of the individual's HSP and within the reference interval.", 'HPV-pos/cyt-neg women continue to have an increased CIN3+ risk, also when the repeat HPV test is negative.', 'The detection of an increasing number of late effects should not be considered as a drawback of HSCT .', 'HAEC was noninferior to HARES measured as mean change from baseline in WSRS score at 6 months.']


Cluster  1835
['A co-occurence matrix of size N x JDJ is finally built by computing those frequencies over all the N possible sequences of words . some of the system timex-values could be incorrect', 'In cases like this , using the whole sample would pose the risk of drawing false conclusions on the usage of ACWs , possibly influenced by stylistic properties of individual speakers . low co-occurrence probability in tweets', 'In cases like this , using the whole sample would pose the risk of drawing false conclusions on the usage of ACWs , possibly influenced by stylistic properties of individual speakers . low co-occurrence probability in tweets', 'Table 3 shows that the performance of Twitter corpus is much improved since the multiple seed words alleviate the problem of low co-occurrence probability in tweets']


Cluster  2363
['Drug abuse is a serious problem in the United States and in the world .', 'Substance abuse is a serious global problem that is affected by multiple psychosocial and socio-demographic factors .', 'The global substance use problem is a serious public health concern that affects not only health , safety and well-being of communities , but also social and economic development .', "Addiction has surpassed the boundaries of health and treatment and turned into a social crisis and a debilitating and major concern in today 's world .", 'Addiction is a serious health problem which leads to general social impairment .', 'Deleterious health sequelae caused by licit and illicit substance use is a serious problem in our society .', 'Emergence of new addictive substances and progressive increase of \' drug abuse " has become a serious problem in many countries .', 'Substance abuse remains a serious medical , public health , and social problem .', 'Drug dependence is a serious health and social problem .', 'The abuse of drugs has become a serious social problem worldwide .', 'Substance abuse and dependence is a serious problem throughout the world .', 'Drug addiction is a serious health problem prevalent worldwide .', 'Drug addiction continues to be a serious medical and social problem .', 'Drug abuse is still a serious problem of nowadays .', 'Illicit drug use is a serious public health problem associated with significant co-occurring medical disorders , mental disorders , and social problems .', 'Drug addiction is a devastating health problem that is a very heavy burden on the individual affected and the society in general .', 'Drug misuse is a serious public health problem .', 'Substance use disorder is a serious public health problem .', 'Drug abuse is a serious public health problem .', 'Drug addiction is a serious problem worldwide .']


Cluster  1018
['The experimental group showed significant differences in horizontal movement (p\u200a=\u200a0.', 'Kinetic effects varied among participants.', 'All measured APPs initially were significantly increased, but the magnitude of increase was not correlated to disease severity.', 'By days 7 and 8, the descriptive-plus-injunctive norm group reported significantly more steps relative to the control group, whereas the descriptive norm group showed a trend toward higher step counts relative to the control group.', 'Climbers were able to perform significantly more moves (P=0.', 'Task-specific effects were similarly positive across groups, but no transfer was seen to gait or function.', 'The heavy back squat group resulted in a significantly (p < 0.', 'There was a significant difference in muscle activation between the squats in terms of speed (fast, moderate, and slow squat) (p< 0.', "AVG's can elicit physiological responses that meet recommended exercise intensities but are more enjoyable than conventional exercise in young inactive adults."]


Cluster  1075
['Ever since the first percutaneous transluminal angioplasty ( PTA ) was carried out in Switzerland in 1977 , restenosis remains a major drawback of this minimally invasive treatment intervention .', 'Recurrent in-stent restenosis after balloon angioplasty poses a serious management problem .', 'Reoccurrence of restenosis following angioplasty of renal instent restenosis is a considerable drawback of stent-supported angioplasty of renal artery stenosis especially in small vessel diameters .', 'However , despite significant advances in reducing the incidence of acute complications , chronic restenosis of dilated lesions remains a serious and frequent problem .', 'Although the concept of coronary stenting significantly improved the interventional therapy of coronary artery disease , restenosis remains a major unsolved drawback of this technique .', 'Restenosis is a serious problem limiting the long-term efficacy of percutaneous transluminal coronary angioplasty .', 'In-stent restenosis still remains a serious clinical problem .', 'Restenosis after percutaneous coronary intervention continues to be a serious problem in clinical cardiology .', 'Although substantial progress in catheter and stent design has contributed to the success of percutaneous transluminal angioplasty ( PTA ) of atherosclerotic disease , the incidence of restenosis caused by in-stent neointimal hyperplasia remains a serious problem .', 'The occurrence of in-stent restenosis is a major drawback of percutaneous transluminal coronary angioplasty with stent placement .', 'Restenosis after coronary intervention has remained a vexing problem despite the introduction of nearly 24 newer coronary interventional devices .', 'Restenosis after percutaneous coronary intervention remains a serious clinical problem .', 'Intimal hyperplasia is a serious problem after percutaneous transluminal coronary angioplasty ( PTCA ) .', 'Restenosis after angioplasty is a serious clinical problem that can result in re-occlusion of the coronary artery .', 'Coronary stents are playing an effective way of curing cardiovascular diseases while a major drawback of restenosis is in general still present .', 'Despite significant advances in reducing the acute complications of percutaneous revascularization procedures with periprocedural medications and better techniques , chronic restenosis of dilated lesions remains a serious and frequent problem , occurring in 30 % to 50 % of cases .', 'Intimal hyperplasia is a serious problem after percutaneous transluminal coronary angioplasty .']


Cluster  1686
['Its high rate of disability and mortality has become a serious social and public health problem .', 'It is also a preventable health problem .', 'Thus , MSA represents a serious health and social problem .', 'It is still a serious problem in developing countries as our country .', 'It is considered a major health problem in developing countries , although it is not a serious concern for the general U.S. population .', 'It is a serious health problem resulting in approximately 50,000 visits to the emergency department and is responsible for 3500 deaths annually in the United States .', 'Therefore , it is not surprising that this disorder constitutes a serious public health concern .', 'In addition , it is considered , at present , a serious public health problem , ranking fourth in mortality worldwide .', 'It is becoming a serious public health problem because of the damages caused to human health as regards its limitations to life quality , the incapacity to work , followed by illness and death .', 'Yet , it is a preventable public health problem .', 'Despite its relatively low prevalence it remains a serious medical and social problem .', 'Its abuse in many countries , including the United States , is a serious public health concern .', 'It is a serious public health problem in many developing countries and can result in deficits in growth and cognitive development .', 'MSF still poses a serious health problem in the country as severe , complicated cases with lethal outcome occur .', 'It is a common as well as a serious health problem worldwide , which is often linked to disability and mortality .']


Cluster  369
['In this cohort of patients, there was a high prevalence of HTN and while hypertensive subjects had a significantly higher NSVT burden, NSVT was not associated with an increased mortality.', 'The majority of patients with hs-cTnT above the 99th percentile did not have structural heart disease or ischaemic coronary disease.', "To assess the level of knowledge among primary healthcare nurses' in the screening of arterial hypertension.", 'Thirty percent ( 30 % ) of participants believed hypertension was not a serious problem .', 'Pilot study in patients without known heart disease and elevated hs-cTnT measured at presentation to the emergency department.', 'Currently, primary care nurses in the studied region do not have sufficient theoretical knowledge to detect hypertension.', 'Furthermore , 73 % of hypertensives believed hypertension was not a serious problem , and required no regular medication .']


Cluster  562
['Child maltreatment ( CM ) constitutes a serious public health problem in the United States with parents implicated in a majority of physical abuse and neglect cases .', 'Child abuse is a serious problem affecting the pediatric population , which has tremendous medical and social implications .', 'Child abuse is still a severe social and psychological problem , and child neglect is more common than child abuse .', 'Child maltreatment is a serious and preventable public health problem .', 'Child maltreatment is a serious public health concern , and its detrimental effects can be compounded by traumatic experiences associated with the child welfare ( CW ) system .', 'Child abuse continues to be a serious problem that is likely to be encountered in all medical specialties , with orthopaedic surgeons commonly evaluating children having sustained musculoskeletal injuries .', 'Child abuse is a serious health problem , which threatens children and has a wide reaching effect on family and society .', 'Child maltreatment is a serious problem in US society , affecting approximately three million children .', 'Child abuse is a serious social health problem all over the world with important adverse effects .', 'This study provides strong indications that child abuse is a serious public health problem based on the clear links seen between abuse and poor health and behavioral problems .', 'Child maltreatment remains a serious but potentially preventable public health concern in the United States .', 'The neglect of children is a serious global problem .', 'Neglect is a frequent type of child maltreatment and a serious problem worldwide , but it has received limited research attention .', 'Child maltreatment is a serious and prevalent public health problem , which has been shown to be associated with numerous short- and long-term effects on mental and physical health .', 'Childhood abuse is a serious and prevalent public health concern , both in the United States and around the world .', "Awareness of child abuse as a serious social problem has risen sharply in recent years , yet there has been only limited and inadequate research on the abused child 's growth and development .", 'Child abuse remains a serious and expensive social problem in the United States .', "Child abuse is a serious public health problem and affects the victims ' physical and mental health and development .", 'Child maltreatment is a serious public health concern in the United States .', 'Child abuse and neglect ( CNS ) increasingly have become a serious problem in modern society all over the world .', 'Child abuse is a serious problem , and its physical manifestations can be mimicked by certain diseases and conditions .', 'Detecting and responding to child-maltreatment is a serious challenge and public health concern .', 'Child abuse and neglect ( CAN ) is a serious problem that has major implications for the welfare of the child involved .', 'Child maltreatment is a preventable public health problem .', 'Childhood trauma due to physical abuse , neglect , or sexual abuse is a serious problem in the United States .', 'Child abuse and neglect is a serious social problem with global dimensions .', 'Child maltreatment is a severe worldwide public health problem because of its negative consequences and should therefore be prevented through parenting programs to improve parental behavior and practices .', 'Physical abuse of children is a severe social problem and is usually identified by the presence of bruises of various ages .', "Child abuse and neglect , or maltreatment , is a serious public health problem , which may cause long-term effects on children 's health and wellbeing and expose them to further adulthood vulnerabilities ."]


Cluster  1772
['Problem gambling is a serious global public health concern due to adverse personal and social consequences .', 'Gambling is a serious concern for society because it is highly addictive and is associated with a myriad of negative outcomes .', 'Rather , it is a serious problem in the gambling literature .', 'Pathological gambling ( PG ) is a severe and persistent pattern of problem gambling that has been aligned with obsessive-compulsive disorder ( OCD ) .', 'A cohort of 2,171 substance abusers were assessed for their gambling behavior , and divided into three groups : those with no significant gambling problem ( 87 % ) ; those with a probable problem ( 7.2 % ) ; and those with a severe problem ( 5.8 % ) .', 'Pathological ( compulsive ) gambling is a serious emotional and social problem that has existed for centuries but has only recently been recognized as a distinct diagnostic entity that can be effectively treated .', 'Problem gambling emerges as a serious and ever growing problem of modern societies , largely affecting adolescents as well .', 'Gambling in children and adolescents is a serious and relatively common problem especially among Czech boys .', 'The findings from this study confirmed that gambling has the potential to become a serious health problem among elders .', 'Although gambling disorder is a serious social problem in modern societies , information about the behavioral traits that could determine vulnerability to this psychopathology is still scarce .', 'Relapse is a serious challenge in problem gambling ( PG ) , as it is in substance addiction .']


Cluster  7
['Resistance due to New Delhi metallo-β-lactamase ( NDM ) and OXA-48/181 continues to emerge as a threat which is associated with nosocomial outbreaks and is a serious healthcare concern .', 'Carbapenemases , which are β-lactamases with the capacity to hydrolyze or inactivate carbapenems , have become a serious concern as they have the largest hydrolytic spectrum and therefore limit the utility of most β-lactam antibiotics .', 'The spread of Extended-Spectrum beta (β)-Lactamases (ESBL)-producing Enterobacteriaceae has become a serious global problem .', 'The emergence of metallo-β-lactamase (MBL)-producing Enterobacteriaceae is a serious public health concern .', 'The variety of extended-spectrum beta-lactamases found among members of the family Enterobacteriaceae isolated from major medical centers in South Africa is troubling and adds to the growing list of countries where these enzymes pose a serious problem for antimicrobial therapy .', 'Also , the emergence of metallo-beta-lactamases (MBL)-producing bacteria is becoming a severe therapeutic problem .', 'The spread of carbapenem-resistant Enterobacteriaceae ( CRE ) mediated by New Delhi metallo-β-lactamase ( NDM ) poses a serious challenge to clinicians and has become a major public health concern .', 'Extended-spectrum beta-lactamases and AmpC beta-lactamase producers among Enterobacteriaceae isolates from this ICU continued to be a serious therapeutic problem , although the carbapenems were highly active against these resistance phenotypes .', 'In contrast , extended spectrum beta lactamases ( ESBL ) and colistin resistance are becoming a serious problem in animals .', 'Infections caused by extended-spectrum β-lactamase (ESBL)-producing bacteria have become a serious clinical concern worldwide .', 'The UTIs which are caused by multidrug resistant Extended-Spectrum Beta-Lactamase ( ESBL ) producing bacteria further pose a severe problem , as the treatment options are limited .', 'The continuing evolution of beta-lactamases that are capable of hydrolyzing our most potent beta-lactams presents a vexing clinical problem , in particular since a number of them are resistant to inhibitors .', 'Infections caused by Enterobacteriaceae producing extended-spectrum β-lactamases ( ESBLs ) are a serious therapeutic and clinical problem .', 'Production of AmpC and extended spectrum beta-lactamases among urinary isolates has created a serious problem to the successful management of the urinary tract infection .', 'Infections with bacteria that contain hydrolytic beta-lactamase enzymes are becoming a serious problem in the United States .', 'Resistance to a wide variety of common antimicrobials has made the proliferation of Extended spectrum β-lactmase ( ESBL ) producing strains a serious global health concern that has complicated treatment strategies .', 'Multiresistant Enterobacteriaceae producing extended-spectrum β-lactamases ( ESBL ) constitute a serious healthcare concern .', 'The global dissemination of metallo-ß-lactamase (MBL)-producing carbapenem resistant Enterobacterales ( CRE ) is a serious public health concern .', 'Metallo-β-lactamase ( MBL ) producing bacteria constitute nowadays a serious global concern worldwide .']


Cluster  980
['Heavy metal contamination is a serious environmental problem commonly monitored in various organisms .', 'Toxic metal pollution in the coastal ecosystem is becoming a serious problem , particularly in developing countries as a result of the industrial revolution .', 'Metal pollution is a serious problem for environmental safety and programmes of monitoring and bioremediation are needed .', 'Contamination of long-term sewage effluent irrigated soils by potentially toxic elements ( PTEs ) is a serious concern due to its high environmental and health risk .', 'Metal contamination of estuaries is a severe environmental problem , for which phytoremediation is gaining momentum .', 'Due to the utilization of landfill technology and geothermal energy production in Tibet , the contamination of the soils and underground water by trace element has currently become a serious problem , both ecologically and to the human health point of view .', 'Environmental pollution by potentially toxic elements ( PTEs ) has become a serious problem with increasing industrialization and the disturbance of natural biogeochemical cycles .', 'Metal contamination in aquatic environments is a severe global concern to human health and aquatic ecosystems .', 'Metal pollution has been a serious problem facing river systems worldwide , which can adversely affect human health through food chain .', 'Heavy metal pollution represents a serious problem facing many of the aquatic organisms .', 'The heavy metal pollution in soils and aquatic environments is a serious ecological problem .', 'The presence of trace elements in marine habitats is a serious environmental problem which increasingly affects ecosystem and human health .']


Cluster  823
['The onset time of sensory block was shortened (9.', 'For the initial phase of this study, 150 healthy participants were randomly assigned to one of 5 experimental groups (2mA anodal, 2mA cathodal, 1mA anodal, 1mA cathodal, or sham) across 3 different conditions (orbitofrontal, bilateral, or extracephalic reference electrode location).', 'Twenty healthy male subjects were randomly assigned to the electrical stimulation group (ESG) or control group (CG).', 'A problem with any study in the waking and alert human is that the subject may not be able to completely ignore stimuli , in spite of instructions to do so .', 'A drawback of this approach is a decreasing magnitude of flexion reflex to repeated presentations of the stimuli ( habituation ) .', 'Extensions to a group-level suffer from the drawback of evaluating single-subject resting-state components of interest either using a predefined spatial template or via visual inspection .', 'The principal drawback is linked to the loss of upper limb proprioception , in a way that dramatically influences even a good motor recovery , so in complete BPLs the sensory loss still represents a debilitating problem .', 'Subjects undergoing GH stimulation testing were invited to participate in the study.', 'The expansion of the sensory (P ≤ 0.', 'Subjective sensations were influenced by treatment mode, with MA and VA yielding higher stimulation responses compared with SA.', 'Thirty asymptomatic participants were assessed and randomly allocated to either a control, sham or mobilization group, where they were all given a neurodynamic test and ROM was assessed.']


Cluster  1145
['Our findings support that BBT represents a complementary rehabilitative strategy, based on visual deprivation and proprioceptive perturbation in recovery of gait in PD patients, in short time window, likely involving vestibular system and its connections with motor areas.', 'Minimal differences were observed, between or within the 2 different stem designs during gait at the 2 follow-up occasions.', 'Results from this study showed that the functions of the PIFMs most likely include shock absorption and facilitation of efficient foot ground force transmission during the stance phase of gait.', 'The impact of a WW can be quantified objectively by instrumented gait assessment.', 'Gait parameters were measured using the GAITRite system.', 'To study functional and structural brain changes induced by gait rehabilitation.', 'We found a decrease of stance and double stance phase and increase of swing phase respect to gait cycle, in BBT group compared to PT group, paralleled by a selective modulation in functional connectivity between M1 and SMA for BBT group.', 'This study explored the effects of prolonged superficial cooling and warming of the lower leg on walking speed and local measures of neuromuscular impairments.', 'Twenty-one healthy subjects (aged 20-65 years) were recruited for gait analysis.', 'The goal of this study is to determine gait adaptations in PD and healthy subjects during positive pressure BWSTT and post-intervention overground walking.', 'A significant difference was found immediately after postural insole placement regarding anteroposterior range of movement (p\xa0<\xa00.', 'This study focusses on two common problems of gait analysis under single-task (ST) and dual-task (DT) conditions (visual verbal Stroop test): (1) reproducibility of walking variables and (2) the effects of gait velocity, gender and age on peak plantar pressure to identify confounding effects on relevant outcome parameters.', 'The use of a WW improved the risk of spatio-temporal parameters velocity, swing time, stride length and the sagittal plane associated parameters heel strike and toe off angles in all patients.', 'The study provided basic data about foot pressure distribution and time of maximum pressure in subjects with MS.', 'The effects of age and speed on foot and ankle kinematics in gait studies using foot models are not fully understood, whereas this can have significant influence.', 'Superficial cooling significantly reduced walking speed for people with HSSP.', 'The findings of this study suggest that geometrical restoration during THA impacts postoperative gait pattern and, in addition to known factors such as FO, height of hip rotation center, and leg length discrepancy, the FNA must also be taken into consideration.']


Cluster  650
['Malaria was the most significant vector borne disease constituting a serious healthy problem until it was suppressed in 1965 .', 'The paper concludes by arguing that malaria in urban India is a serious problem that can not be neglected .', 'Despite tremendous progress , malaria remains a serious public health problem in Pakistan .', 'Regarding degedege as a separate entity may explain why malaria is not perceived as a serious health problem in the area , and why little preventive actions are taken .', 'The results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province , Iran .', 'The rate of malaria decreased (19.', 'Although there is acceptable knowledge ( about 80 % of the subject knew that mosquito bite causes malaria ) and positive attitude towards malaria ( 100 % of respondents agreed that malaria was a serious health problem in this area and 97 % of respondents agreed that they would like to participate in malaria control activities ) , it is necessary to increase the community awareness of the transmission of the disease , its consequences and ways and means to control the disease to a minimum , especially in endemic areas .', 'Despite being a serious public health concern , the geographical distribution of P. knowlesi malaria risk is poorly understood because the parasite is often misidentified as one of the human malarias .', 'Malaria remains a serious problem for ADF soldiers deploying to malarious areas , particularly the incidence of relapsing vivax malaria and the tolerance of these vivax strains to primaquine .', 'Malaria around the China-Myanmar border is a serious health problem in the countries of South-East Asia .', 'Though intensive antimalaria efforts in Turkey have been successful in bringing down the number of cases , historically malaria was a serious public health concern .', 'Parental and environmental context associated with severe malaria for children under 5 years of age remains a serious public health problem that affects malaria outcomes in resource-limited areas .', 'Connected with perinatal diseases as well as gastrointestinal and respiratory infections malaria has been still a serious health problem of that region .', 'Malaria is still a serious public health problem in the world and control remains a major priority for the approximately 25.000 French troops deployed , mostly on permanent assignment , in malaria transmission regions .', 'In order to reduce the risk of imported malaria, educational actions should target potential VFR travelers, and they should underline the different risk of severe malaria in adults and children.', 'malaria is considered to be a serious health problem in Haiti , mainly in the rural zones of the coastal area located at 600 m above the sea level , particularly shallow zones with rice crops .', '92.5 % of the study population considered malaria to be a serious health problem , thus reflecting their attitude to the disease .', 'Conclusions : The disability and inability to work and its legal consequences , such as indemnity , demonstrate that malaria may present a serious socioeconomic problem , even in the country where it is an imported disease .', 'Imported malaria poses a serious public health problem in Qatar because its population is " naïve " to such infection ; where local transmission might lead to serious , life-threatening infection and might even trigger epidemics .', 'Malaria is a serious health problem in many of the countries from which refugees come to Australia .', 'Although great success has been achieved since the launch of the National Malaria Control Programme in 1955 , malaria remains a serious public health problem in China .', 'While Iran is on the path to eliminating malaria , the disease with 4.9 million estimated cases and 9300 estimated deaths in 2018 remains a serious health problem in the World Health Organization ( WHO ) Eastern Mediterranean Region .', 'Malaria is still a serious health problem in Thailand .', 'Malaria was a serious problem in 39.6 % of the families surveyed in June 1999 .', 'Participants understand that malaria is a serious problem that no single tool can defeat .', "Malaria and Chagas ' disease continue to be a serious problem in endemic areas , but are also of concern as a result of their introduction into other regions .", 'Malaria is a leading cause of imported febrile illnesses in pediatric travelers, but few studies have addressed severe imported pediatric malaria']


Cluster  506
['From May 2016 to December 31, 2017, 1607 patients were enrolled in the HOPES registry.', 'Between March 2010 and November 2013, 921 patients (LADG 462, ODG 459) were enrolled from 33 institutions.', 'Ninety-five patients were enrolled; 23 had ≤12th grade level education and 7 scored ≤8th grade on the REALM-SF.', 'A total of 288 children diagnosed with ARF were transported.', 'Twenty-nine new patients with Down syndrome visited our clinic during this period.', 'Over 10,000 patients were moved 34,715 times in 1\xa0year which equates to an average of 2.', 'Thirty patients were enrolled until September 2015.', 'Additionally , in cases with concomitant Down syndrome , recurrent infections can be a serious problem in patients ( pts . ) waiting for cardiosurgery treatment .', 'Patient data obtained in the HOPES registry include demographics, comorbid diagnoses, medications, health behaviors, laboratory values, imaging studies, vital signs, and outcome measures, most notably the modified Rankin Scale (mRS) at 90days.', 'Registered on Clinicaltrials.gov on March 1, 2019 (NCT03859973).', 'We identified a total of 132 patients, all of whom were transferred to our center, from April 2014 to April 2017.']


Cluster  2156
['Minimizing blood loss is essential , while supportive measures in postoperative multiple systems failure still remain a serious problem .', 'Preoperative levels of erythrocytosis appear to predict postoperative blood loss and short-term mortality in TOF patients undergoing corrective surgery.', 'The mean intraoperative bleeding volume was 64.', 'The aim of this study was to compare the effect of two different ventilator modes (inspiratory to expiratory ratio [I:E ratio] of 1:1 and 1:2) on intraoperative surgical bleeding in patients undergoing posterior lumbar interbody fusion (PLIF) surgery.', 'The drained blood volume in groups A and B was significantly less than that in group C. No significant difference was found between groups A and B. The level of hemoglobin in group A was significantly higher than that in group C at 2\xa0days after surgery.', 'Blood flow increased significantly in controls on all 3 postoperative days (p < 0.', 'Compared to conventional ratio ventilation, ERV provided lower PIP and reduced intraoperative surgical blood loss in patients undergoing PLIF surgery.']


Cluster  1926
['Cancer-related fatigue ( CRF ) is a serious clinical problem and is one of the most common symptoms experienced by cancer patients .', 'Fatigue is a serious problem for the majority of patients with cancer .', 'Findings revealed that fatigue is a serious problem for some young adult survivors of childhood cancer and affects many aspects of quality of life .', 'Fatigue is a distressing and pervasive problem for people with cancer .', 'Fatigue remains a severe problem in breast cancer patients , especially in younger women .']


Cluster  500
['Fifty patients aged 25 to 90 years (34 females), who had a mean follow-up of 6,3 years (range 4-14 years), were selected.', 'All patients completed the follow-up (median follow-up was 25 (range, 17-40) months.', 'Median patient age was 2 years (range, 2 months-14 years).', 'There were 50 patients in the study, of whom 28 (56%) completed the 24\xa0weeks of treatment and 27 (54%) completed the 12-week post-treatment follow-up.', 'Twenty-two patients (44%) were still assessable at the end-of-study visit, whereas 33 (70%) were assessable at the same time point in the TENS-TEP group (P\u200a=\u200a.', 'One month after the last session, regarding clinical response, 35.', 'Ninety two patients (42 females) between June 2013 and August 2016 met inclusion criteria.', 'The average age of patients was 2years (range, 4months to 5years).', 'Of the initial 163 patients randomized (Nissen 84, anterior 79), 90 (55·2 per cent) completed 12-year follow-up (Nissen 52, anterior 38).', 'Patients will have follow-up for 1\xa0year, and continuous loop monitoring is advocated.', 'We analyzed the clinical results in the last 100 consecutive patients with a follow-up of 6-42 months at our institution.', 'The total of 97 patients, aged 6 months to 5 years, were recruited from June 2014 to November 2015.', 'There were 4 patients (3 females, age group 3 months to 3 yr, follow up 6 months to 20 months.', 'Fifty-eight patients (30 females) commenced therapy in the period June-August 2015.']


Cluster  520
['During SR, 14 (47%) patients had low-voltage (0.', 'At baseline, SSR amplitude was higher in patients versus healthy volunteers (p<0.', 'Reversal of regadenoson with aminophylline is safe and equivalent to adenosine for FFR measurements.', 'The lack of concordance between sympathetic arousal and SUDS indices highlights the limitations of relying solely on SUDS with pediatric populations.', 'Significant differences in electrogram voltage and fractionation degree may exist between SR and AF at the same locations in patients with persistent AF.', 'For FFR measurement, regadenoson and adenosine are equivalent hyperemic agents.']


Cluster  525
['The baseline characteristics were almost similar between the placebo and allopurinol groups.', '480 patients undergoing gastroscopy and colonoscopy were recruited and randomly divided into four groups to receive different doses of butorphanol (Group A\u2009=\u20092.', 'Allopurinol administration in patients undergoing PCI failed to show efficacy in preventing CIN.', 'Baseline characteristics were similar between 63 sham fed patients and 59 controls.', 'Data were collected from the medical charts of patients treated with low-dose propranolol from December 2009 through November 2011.', 'In this double-blind placebo-controlled trial, patients with an estimated glomerular filtration rate ≥60\xa0mL/min who were admitted for elective PCI, were randomized to receive either allopurinol 600\xa0mg or a placebo administered 24\xa0h before the procedure, and again immediately before the procedure.']


Cluster  867
['Current physiologic pacemakers : a serious problem with a new device .', 'Thirty patients with indications for long-term cardiac monitoring underwent successful insertion of a study device.', 'Our experience shows that remote monitoring in a pacemaker population can safely replace in-clinic follow-up, avoiding unnecessary in-hospital device follow-up.', 'Aquarel scores were significantly higher in patients with remote device monitoring system regarding chest discomfort and arrhythmia subscales the first month after PM implant and remained stable until 6\xa0months.', 'Health-related quality of life (HRQoL) improves shortly after pacemaker (PM) implantation.', 'Rapid left ventricular pacing was provided via the back-up 0.', 'Runaway pacemaker . A serious and unresolved problem .', 'Consecutive pacemaker patients followed with remote monitoring were prospectively included by 6 Italian cardiology centers in an observational investigation.', 'Unipolar DDD pacing bears a high risk of false triggering of the WCD detection algorithm.', 'Sixty patients with implanted pacemakers received the WCD for a short time and each pacing mode (AAI, VVI, and DDD) was tested for at least 30 seconds in unipolar and bipolar pacing configuration.', 'MRI-induced heating on endocardial leads is a serious concern for the safety of patients with implantable pacemakers or cardioverter-defibrillator .', 'This was a pilot prospective double crossover randomized controlled clinical study comparing ventricular back up pacing (VVI-40), RV fusion pacing (DDD-40, RV only), and biventricular (BIV) pacing (DDD-40 BIV) in nine patients with RBBB and depressed EF.']


Cluster  160
['Alitretinoin is the only approved treatment for severe chronic hand eczema (CHE) refractory to potent topical corticosteroids.', "Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that severely impairs patients' quality of life (QoL)", "Grover's disease (GD) is a relatively rare transient dermatosis that can be idiopathic or acquired", 'Chronic hyperkeratotic dermatitis of the palms and soles represents a severe multi-etiological problem , too often faced with ineffective or tedious topical remedies .', 'We confirm the variation in cutaneous lesions and their time of onset in neonates.', 'Pediatric erythroderma is a severe cutaneous disorder , which may pose diagnostic and therapeutic challenges .', 'Hand dermatitis was seen in 177 (13.', 'The high prevalence rates and clinical degree make skin diseases a severe public health problem in Sierra Leone .', 'The severity of the skin lesions posed a serious welfare problem .', 'Children who suffer from this form of epidermolysis bullosa hereditaria present a severe problem .', 'This study was undertaken to evaluate the clinical and etiologic profile and review the patch responses of patients who presented with hand dermatitis at a foremost tertiary skin clinic in the most populous state of the most populous country in Africa.', 'Consecutive cases with incident NMSC were recruited in Dermatologic Unit at University of Trieste; controls were recruited in Unit of Occupational Medicine.', 'Is Microsporum canis infection about to become a serious dermatological problem ?', 'Alterations in skin integrity represent a serious problem in the pediatric inpatient setting .']


Cluster  1934
['However , MTX-induced pulmonary toxicity is a serious and unpredictable side effect of the therapy , which includes allergic , cytotoxic or immunologic reactions , and is a major clinical problem .', 'Severe myelosuppression is a serious concern in the management of rheumatic disease patients receiving methotrexate ( MTX ) therapy .', "Drug survival of MTX was low with 15% of patients 'on drug' after 5\xa0years.", 'This study will evaluate the trough levels and the need for adaptation of therapeutic doses in de novo LTx patients treated with Tacrolimus in the clinical routine, without any intervention to the treatment regimen.', 'MTX-induced pneumonitis has been a serious unpredictable side effect of the treatment and an important clinical problem .', 'We included 85 patients treated with MTX, with a maximum treatment duration of 5·2\xa0years.']


Cluster  1127
['Controversy exists regarding whether the kinesiology tape application direction affects muscle strength.', 'The application of kinesiology tape application to the rectus femoris, vastus medialis, and vastus lateralis of the quadriceps increased the muscle torque, regardless of the tape application direction.', 'After taping, participants in the experimental group showed significant improvement in the Berg Balance Scale, gait speed, and 6-minute walk test.', 'The present study aimed to investigate whether the direction of cross tape application affected the outcomes of the modified O-ring test and maximal pinch strength using a pinch gauge and the conformity between these 2 tests when cross tape was applied to the forearm muscles of individuals with no upper extremity pain and no restriction of joint range of motion.', 'This manuscript describes the protocol for developing and evaluating TAPES.']


Cluster  1801
['The accumulation of phosphorus ( P ) and metals is a serious concern with the continuous application of manure to agricultural soils .', 'Phosphorus ( P ) leaching from agricultural soils is a serious environmental concern .', 'The waste products of the fertilizer industry such as heavy metals , but especially phosphates and sulphates , are a serious problem that influences the structure and functioning of ecosystems .', 'Phosphorus ( P ) eutrophication of lakes and streams , coming from drained farmlands , is a serious problem in areas with intensive agriculture .', 'Shortage in phosphorus ( P ) resources and P wastewater pollution is considered as a serious problem worldwide .', 'Excessive P application through mineral fertilizer in the arable farming system has led to the accumulation of soil P and constituted a risk to the recipient water quality , whereas the grassland grazing system is confronted with a severe P deficit problem which has resulted in widespread grass degradation .', 'Nonpoint phosphorus ( P ) pollution from animal manure is becoming a serious global problem .', 'Agricultural non-point source phosphorus pollution is a severe problem for rural water bodies in China , but hard to control directly because of its special characteristics .']


Cluster  1320
['Sepsis is a serious and growing health problem among patients admitted to intensive care units .', 'Sepsis , a life-threatening organ dysfunction caused by a dysregulated host response to infection , is a major public health concern with high mortality and morbidity .', 'Bacterial sepsis is a life-threatening disease and a significant clinical problem caused by host responses to a microbial infection .', "Serious infection and the patient 's response ( sepsis ) is a serious health problem that , even today , is associated with a mortality rate of 30 \xa0 % -50 \xa0 % .", 'Sepsis , a life-threatening organ dysfunction caused by infection , is a major public health concern with limited therapeutic options .', 'Sepsis is a devastating problem that has eluded a solution , despite the introduction of highly effective antimicrobial agents .', 'Sepsis is a threatening health problem and characterized by microvascular dysfunction .', 'Sepsis is a severe public health problem affecting millions of individuals , with global mortality rates caused by lower respiratory tract infections are approximately 2.38 million people a year die from respiratory failure caused by infection .', 'Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma , or in intensive care and infection , etc .', 'Sepsis remains a serious clinical problem despite intense efforts to improve survival .', 'Of total 5485 ICU admissions during the study period we identified 647 unique patients with severe sepsis or septic shock.', 'Sepsis remains a serious clinical problem despite continuous efforts to increase survival .', 'BACKGROUND Sepsis is a serious clinical problem that results from the systemic response of the body to infection .', 'Sepsis-induced cardiac dysfunction is a severe clinical problem .', 'Mortality from sepsis is influenced by multiple factors.', 'Sepsis is not only a threat to the health of individual patients but also presents a serious epidemiological problem .', 'Sepsis is a serious clinical problem involving complex mechanisms which requires better understanding and insight .', 'Sepsis is a serious global health problem .', 'Sepsis is a syndrome caused by uncontrolled systemic inflammatory response of the individual , which represents a serious epidemiological problem worldwide .', 'Sepsis remains a serious clinical problem , and multiple attempts at blocking inflammation have failed to decrease mortality rate .', 'The heart is one of the target organs susceptible to attack by sepsis , and protection of the cardiac function in sepsis or alleviation dysfunction caused by sepsis appears a serious and urgent problem .', 'Despite its existence since the time of Hippocrates ( 470 \xa0 BC ) , sepsis is still a serious medical problem for physicians working in both pediatric and adult intensive care units .', 'Sepsis has always been a severe clinical problem in critical care medicine due to its rather high mortality and poor prognosis .', 'Sepsis is a serious clinical problem .', 'Sepsis remains a serious clinical problem despite intense efforts to improve survival .', 'Sepsis remains a serious problem in critically ill patients with the mortality increasing to over half when there is attendant acute kidney injury .', 'Sepsis is a serious clinical problem which arises due to the excessive host inflammatory response to infection .']


Cluster  332
['A typical text consists of sentences glued together in a systematic way to form a coherent discourse . the complexity it introduces into an ( up till now ) quite simple story', 'A typical text consists of sentences glued together in a systematic way to form a coherent discourse . the complexity it introduces into an ( up till now ) quite simple story', 'As context for a word , we consider the sentence in which this word occurs . as the complexity of the sentences recognized increases , the computational complexity increases quadratically', 'If we try to grade the seven texts of the shared task -LRB- Bos , 2008 -RRB- , from the point of view of their intrinsic semantic complexity we should get the following picture : discontinuous constituents in natural language parsing', 'As context for a word , we consider the sentence in which this word occurs . as the complexity of the sentences recognized increases , the computational complexity increases quadratically', 'If we try to grade the seven texts of the shared task -LRB- Bos , 2008 -RRB- , from the point of view of their intrinsic semantic complexity we should get the following picture : discontinuous constituents in natural language parsing']


Cluster  260
['We randomly assigned (1:1) 106 patients who underwent lobectomy to either low (-5 cm H<sub>2</sub>O) or high (-20 cm H<sub>2</sub>O) external suction using an electronic chest drainage system.', 'Postoperative pulmonary complications (PPC) in patients with pulmonary diseases remain to be resolved clinical issue', 'To verify the results of non-invasive ventilation as a preventive strategy on the decline of respiratory function and postoperative complications in patients undergoing Roux-en-Y gastric bypass.', 'Postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease has emerged as a serious problem .', 'A drawback of robotic lobectomy is the inability of the operating surgeon to perform stapler division of the pulmonary vessels and bronchi .', 'Ultrasound-guided lung recruitment may be more effective than the conventional procedure in terms of the prevention of intra-operative atelectasis and postoperative desaturation; however, its beneficial effects on postoperative atelectasis remain unclear.', 'The control of aerostasis after performing non-anatomical pulmonary resections constitutes a serious problem .', "HATS overcomes a major drawback of thoracoscopic surgery in allowing full manual palpation of the lungs via a subcostal ( mini-Kocher 's ) incision under videoscopic guidance , avoiding a thoracotomy , when the indication is pulmonary metastasectomy with curative intent or resection of undiagnosed lung nodules .", 'In patients with obesity undergoing laparoscopic bariatric surgery, the use of lung\xa0ultrasound individualized stepwise PEEP approach improved oxygenation, compliance and reduced the incidence of postoperative pulmonary atelectasis and hypoxia without causing hemodynamic\xa0instability.', 'In this study , the incidence of remnant lung lesions ( a drawback of segmentectomy ) was low .', 'While adherent lymphadenopathy is a vexing problem in thoracoscopic lobectomy , minimallyinvasive approaches are safe and effective .', 'Operative morbidity in patients with lung cancer associated with perioperative interstitial pneumonia ( IP ) has emerged as a serious problem .', 'To evaluate and compare the effects of an ultrasound-guided lung recruitment manoeuvre with those of a conventional recruitment manoeuvre on the occurrence of postoperative atelectasis and clinical outcomes in children.', 'Dilatation of the pulmonary autograft is a major drawback of the Ross procedure and it is the leading cause for reoperation in these patients .', 'Even when air leakage has ceased completely after lobectomy, chest drains are often not removed because of high fluid output.', 'Sixteen GGO lesions at "blind areas" in 16 patients were localised with platinum-fibered microcoils under CT assistance before undergoing video-assisted thoracoscopic surgical resections.']


Cluster  1133
['Acute dehydration is a serious concern .', 'A system delivering i.v. fluid in response to subjective thirst corrects fluid deficits in healthy participants.', 'Following a prospective, single-center design we made cross-sectional and longitudinal comparisons of peritoneal water transport in 2 relatively large samples of diabetic and nondiabetic PD patients.', 'The fluid shift was significant between donors without fluids (GI: 127\u202f±\u202f81\u202fml) and donors with fluid intake (GII & III: 96\u202f±\u202f45\u202fml) (p\u202f<\u202f0.', 'Malnutrition is a serious and relatively common problem among hospitalized patients ; moreover , it is known that a good hydration state contributes to health and wellbeing .', 'More fluid was infused in response to thirst than by adherence to NICE guidelines, with a mean difference of 743\xa0ml (P=0.', 'Inadequate fluid intake is assumed to be a trigger of water-loss dehydration, which is a major health risk in aged and geriatric populations.']


Cluster  737
['Our data suggest that muscle volume could be a predictor of graft survival after PT.', 'Skeletal muscle atrophy is a serious concern for the rehabilitation of patients afflicted by prolonged limb restriction .', 'Muscle atrophy poses a serious concern to patients inflicted with inflammatory diseases .', 'While proteasome inhibitors show promise in the attenuation of muscle degeneration , proteasome inhibition-induced toxicity was a major drawback of this therapeutic strategy .', 'Insufficient post-traumatic skeletal muscle regeneration with consecutive functional deficiency continues to be a serious problem in orthopedic and trauma surgery .', 'Muscle atrophy poses a serious concern to patients inflicted with inflammatory diseases .', 'NEMS seemed to have preserved the quadriceps muscle mass in patients with moderate or severe acute stroke.', 'Weakness of proximal muscle that interferes with activities of daily living is a serious problem for patients with steroid myopathy .', 'Muscular dystrophies are genetic muscle disorders, in which heart involvement and chronic respiratory impairment affect survival.', 'Skeletal muscle dysfunction is a serious problem in older adults with CLDs , reducing their quality of life and survival .', 'Volumetric muscle loss ( VML ) is a severe and debilitating clinical problem .', 'Muscle weakness in septic patients is a serious problem as it complicates and lengthens hospital stays , prolongs rehabilitation and increases costs .', 'Skeletal muscle atrophy is a serious concern for patients afflicted by limb restriction due to surgery ( e.g. , arthrodesis ) , several articular pathologies ( e.g. , arthralgia ) , or simply following cast immobilization .']


Cluster  285
['CCR9 and OSM are implicated as novel pharmacodynamic and efficacy biomarkers.', 'Due to the aggressive nature of this malignancy , there is a serious concern for identifying effective targets , and adopting novel strategies for therapy .', 'Adverse vascular events have become a serious clinical problem in chronic myeloid leukemia ( CML ) patients who receive certain BCR/ABL1 tyrosine kinase inhibitors ( TKIs ) .', 'Acquired resistance to imatinib mesylate ( STI571 ) in chronic myelogenous leukemia ( CML ) patients has become a serious clinical problem .', 'Molecular targeted drugs , such as mTORC1 inhibitors , have been clinically popularized for advanced renal cell carcinoma treatment but metastasis is still a serious concern .', 'Primary and secondary resistance to imatinib , a selective receptor tyrosine kinase inhibitor ( TKI ) , is a serious clinical problem in the control of advanced gastrointestinal stromal tumors ( GIST ) .', 'However , cell-type specific and patient-to-patient variability in response to SERMs ( from suppression to stimulation of cancer growth ) , as well as frequent emergence of drug resistance , represents a serious problem .', 'However , because Navitoclax has a low binding affinity to Mcl-1 , anticancer activity by Navitoclax is often attenuated by the elevated expression of Mcl-1 in hepatocellular carcinoma ( HCC ) and other cancers , posing a serious problem for its potential clinical utilities .', 'Resistance to tyrosine-kinase inhibitors is a serious problem in the treatment of chronic myeloid leukemia ( CML ) .', 'Chronic lymphocytic leukemia ( CLL ) , a severe problem all over the world and represents around 25 % of all total leukemia cases , is generating the need for novel targets against CLL .', 'Chronic myeloid leukemia ( CML ) is a severe problem throughout the world and requires identification of novel targets for its treatment .']


Cluster  1720
['Acquired resistance to tamoxifen ( TAM ) is a serious therapeutic problem in breast cancer patients .', 'A considerable proportion of estrogen receptor (ER)-positive breast cancer recurs despite tamoxifen treatment , which is a serious problem commonly encountered in clinical practice .', 'However , acquisition of resistance to tamoxifen in one third of patients presents a serious clinical problem .', 'Tamoxifen resistance is a serious problem in the endocrine therapy of breast cancer .', 'Acquired resistance to tamoxifen ( TAM ) is a serious therapeutic problem in breast cancer patients .', 'Tamoxifen resistance is a serious clinical problem commonly encountered in the management of patients with breast cancer .', 'Acquired resistance to tamoxifen ( TAM ) is a serious therapeutic problem in breast cancer patients , and Her-2/ErbB2 expression is associated with decreased sensitivity to TAM .', 'Development of resistance to tamoxifen is a serious problem in treatment of breast cancer patients .', 'Acquired resistance to tamoxifen ( Tam ) in breast cancer patients is a serious therapeutic problem .']


Cluster  1225
['In patients who responded to treatment, ferric carboxymaltose may require more time to stabilize restless legs syndrome than previously assumed.', 'RLS , despite being a common entity , is often underdiagnosed and appears to be a serious problem from a diagnostic and therapeutic point of view .', 'Being of the most frequent causes of insomnia , which in the end leads to chronic fatigue , inadequate performance of daily activities , and serious disruption of quality of living , restless legs syndrome ( RLS ) is nowadays not only a serious medical problem but a socio-economical one as well .', 'Ferric carboxymaltose treatment (n = 59) led to nonsignificant improvement over placebo (n = 51) in International Restless Legs Syndrome Severity Scale score at week 4 (difference [95% confidence interval], -2.', 'MG patients consider RLS symptoms as a troublesome health problem .']


Cluster  1851
['The prevalence of tobacco use among individuals with mental illness remains a serious public health concern .', 'Tobacco use is known as a serious global public health problem , and is also an important risk factor for oral diseases .', 'Tobacco use remains a serious and persistent national problem .', 'Smoking tobacco by soldiers is a serious health and social problem as its consequences may restrict their occupational efficiency .', 'Tobacco is the leading modifiable cause of cardiovascular disease , cancer , and respiratory diseases and is thus a serious global public health problem .', 'Smokeless tobacco is a serious problem in American colleges and universities .', 'Smoking is a serious problem in prisons .', 'Tobacco smoking among nursing students is a serious problem because of the public role model of these future healthcare professionals .', 'Tobacco smoking is a serious health and social problem .', 'Transnational tobacco companies ( TTCs ) have argued that tobacco-attributable deforestation is not a serious problem , and that the industry has addressed the issue through corporate social responsibility ( CSR ) initiatives .', 'The habit of tobacco use/smoking , which is a major concern of Primary Health Care ( PHC ) , is a serious public health problem and the main avoidable cause of death in the world .', 'Tobacco use among school children is becoming a serious problem in developing countries .', 'Tobacco smoking is a serious health problem worldwide and a leading cause of mortality .', 'Use of tobacco is a serious public health problem in Indonesia that requires a multidisciplinary approach by healthcare providers to address it .', 'Tobacco use among school children is becoming a serious problem .', 'Tobacco use is a serious public health concern as it causes various deleterious health problems .', 'Smoking tobacco by the public service workers is a serious health and social problem as its consequences may restrict their efficiency .', 'Tobacco-attributable hospitalisations pose a serious but preventable problem for the health care system .', 'Despite documented decreases in the prevalence of smoking in Canada , increases in flavoured tobacco use by its youth poses a serious public health concern .', 'Underage tobacco sales is considered a serious public health problem in Los Angeles .', 'The use of contraband cigarettes is a serious public health problem .', 'Tobacco use was rated as a serious problem for Guam by 73 % of the leaders surveyed , and a majority agreed that stricter tobacco control policies were needed on Guam .', 'Active and passive tobacco exposure : a serious pediatric health problem .']


Cluster  2199
['Postnatal growth failure is a serious problem in children with EB .', 'Children suffering from the disease are having a serious problem that affects their lives from its earliest .', 'ZTB is a serious public health problem , and presented as EPTB in children with malnutrition and those who had consumed unpasteurised milk .', 'Deficiency/disability in children is still a serious medical , social and human problem .', 'Although not frequent , EBI remain a serious problem , particularly in adolescent boys , and short- and long-term morbidity are significant .', 'Ca deficiency was discovered to be a serious health problem for rural children , with Ca inadequacies reaching 96 % .']


Cluster  2240
['All of the children had vomiting within 4 h of ingesting the W. floribunda seed; the child who ingested a whole seed began to vomit 2 h after ingestion.', 'Of 28 children in a kindergarten who participated in a field trip, seven ingested W. floribunda seeds: six half of the seed and one a whole seed.']


Cluster  479
['This is a blind, nonrandomized clinical study carried out at a public emergency hospital in the state of Sergipe, Brazil.', 'The prevalence of pain in the main health institutions in Mozambique is high.', 'The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon.', 'Cross-sectional study at Luis Vernaza hospital of Guayaquil, Ecuador.', "A cross-sectional observational study was conducted between August 2018 and January 2019, in Mozambique's main hospitals, and in the only hospital with an isolated provision of palliative care service.", 'An observational and analytical retrospective cohort study conducted at the Mancha-Centro Hospital during the 2010-2014 period.', 'The present study was conducted with the goal of highlighting FN as a serious problem in Pakistan , with the longer term objective of improved cancer survival , reduction in length of stay ( LOS ) in hospital , morbidity , mortality and costs in our existing developing country scenario .', 'Retrospective study in a Brazilian hospital in 194 patients, excluding surgically altered anatomy.', 'The study was conducted at five healthcare centres in Mozambique.', 'This study was conducted at Cairo University Hospital, Egypt from January 2016 to July 2016.']


Cluster  895
['The mean age of the 20 hypertensive subjects (Group 1) and controls (Group 2) was 59.', 'Despite multidrug antihypertensive therapy severe hypertension is still a serious problem in patients on RRT .', 'The problem with understanding primary ( genetic ) hypertension in man is that several genes are involved in the cardiovascular control mechanisms and that the genetics are complex .', 'Subject-level data were extracted from ASCOT (N=18,852) and ALLHAT (N=26,441) databases; both were randomized, active controlled studies, with treatment duration for hypertension ≥4 years.', 'The results of the VICTORY trial show that valsartan and valsartan FDC effectively reduce the BP in patients with mild to moderate arterial hypertension and have a good tolerability profile.', 'In this observational study, we studied 547 patients referred to the hypertension clinic, of whom 224 (40.', 'Fifty-one uncontrolled hypertensives medicated by two or more antihypertensive drugs including a renin-angiotensin system inhibitor and a calcium antagonist were randomly assigned to either the nifedipine CR (80\u2009mg)/candesartan (8\u2009mg) group or the amlodipine (10\u2009mg)/candesartan (8\u2009mg) group.', 'This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial.', 'To establish the diagnosis of resistant hypertension, 69.', 'BRS<sub>preoperative</sub> of hypertensive group (Group H) was lower than normotensive group (Group N) (3.', 'This is a post-hoc analysis of a randomized trial in 24 true resistant hypertensive patients (15 men, 9 women; mean age 64 years) comparing 50mg of spironolactone (n = 13) vs.', 'Age, sex and hypertension were similar in both groups.', 'We enrolled 88 hypertensive outpatients (average age 65 years, 69.', 'Pravastatin reduced the risk of developing hypertension in Japanese patients with hypercholesterolemia.', 'Of the overall (MEGA) Study population, 3397 nonhypertensive patients at baseline were enrolled in this study.', 'Resistant hypertension defined as failure to reach blood pressure targets despite treatment with three antihypertensive drugs including a diuretic represents a serious clinical problem .', 'We have enrolled 105 non-complicated otherwise healthy hypertensive patients: 53 with well-controlled blood pressure and 52 non-controlled.']


Cluster  76
['To evaluate clinically and radiographically the effect of ART on restorations using restorative cement and glass ionomer cement (GIC) for dental caries in the deciduous molars of children aged between 4 and 8 years.', 'Four UG and four PG initially analyzed, by CVCE, 300 primary incisors and molars surfaces of 25 children aged 5-12 years, and choose between no treatment, non-operative, and operative treatment.', 'However , basic tooth structure is usually maintained throughout life , and fractures and dental cavities are not a serious problem as in humans .', 'Sixty extracted molars from young and geriatric patients [18-25 (Y), and 65-80 (O)] were cut buccolingually to prepare enamel (E) and dentin (D) surfaces.', 'This study aimed to stage the third molar development in relation to chronological age of 5-16year old Indian children.', 'Twenty two individuals (11-22 years) were assessed regarding caries, oral hygiene, sugar exposure, salivary flow rate (SFR), buffering capacity, pH, carbonic anhydrase VI (CA VI) and amylase activity, at baseline, 1, 3 and 6 months after the orthodontic appliances placement.', 'Considering the high degree of variability observed in third molar genesis and development, the usefulness of this tooth in age determination studies may be very limited in the age group studied.', "Fifteen isolated Miller's Class I and II gingival recession of single-rooted teeth were selected for the study.", 'This randomized controlled crossover trial comprised 48 children with SHCN requiring at least two dental restorations.', 'The surgical removal of impacted third molars is one of the most common procedures performed by oral and maxillofacial surgeons.', 'The sample for the study consisted of 75 school children aged 8-12 years with four or more (decay component) of decayed, missing, and filled teeth index.', 'The aim of the work was to determine the relationship between the level of HCHO and the levels of its generators in pathologically changed teeth , mainly carietic teeth as tooth caries is still a serious and commonly occurring problem .', 'It represents a serious problem in dentistry as it progresses rapidly and affects young children .', 'There were no significant differences between the old and young teeth surfaces.', 'The problem should be addressed rather from the paediatric than dental point of view and the appearance of a single carious lesion an any tooth surface during the first 3 years of life must be considered a serious health problem .', 'The frequency of occurrence of the third molars varied from 47% to 70%.', 'Panoramic radiographs of 4006 Caucasian children between 9 and 16\xa0years of age (1865 males and 2141 females) performed over a 5-year period (from 2010 to 2015) were carefully examined to identify congenital missing teeth.', 'The ever increasing number of injuries to deciduous teeth in children constitutes a serious problem in paedodontics .', 'The present study demonstrated that saliva of individuals under orthodontic treatment is subjected to changes in properties that have implications on the onset of ACL.', 'Subocclusal dentine thickness ranged between 1.']


Cluster  126
['Intolerable malodor emanating from ulcerated tumors as a result of anaerobic infection is a serious problem in the management of advanced and recurrent breast cancer .', 'To compare cytological findings between two different collection techniques by evaluating the numbers of bacteria, Malassezia yeast and inflammatory cells.', 'The yeast Malassezia pachydermatis is a commensal but also the most isolated pathogenic yeast in canine otitis externa', '99 positive blood cultures in 73 patients with bloodstream infection (16%) were found.', 'After exclusion of microorganisms classified as contaminants, the concordance between SeptiFast and blood culture was 85.', 'Of the patients with adequate microbiology samples, 12% (6/50) grew clinically relevant bacteria resistant to amoxicillin and clavulanic acid.', 'Thirty-six patients were included, 24 with one set of blood cultures positive for S lugdunensis and 12 with multiple sets.', "Results suggested a difference in severity in lesioned samples depending on the strain's spoligotype.", 'Persistent infections by S. Typhimurium are a severe concern for the affected patients .', 'Blood cultures were positive in 230 patients; hence, the prevalence of bacteremia was 12.', 'At baseline, a significant colony-forming unit (CFU) count for Malassezia furfur and Staphylococcus aureus was detected in 4 out of 5 selected patients.', 'The unpleasant smell of infected fungating tumors and benign cutaneous ulcers is a distressing clinical problem , known to be associated with anaerobic infection .', 'Our results suggest that strains belonging to certain spoligotypes may be associated with a higher probability in the occurrence of gross/macroscopic lesions in infected cattle, although these observational findings should be confirmed in further studies that allow accounting for the effect of other possible confounders not considered here, and ultimately through experimental studies.']


Cluster  49
['T-wave oversensing can be a serious problem that often results in inappropriate device therapy .', 'Fibrillatory DPVA was found to be strongly associated with trigger ectopy of AF.', 'Inducibility of any VT at the end of procedure for VT storm guided by RMN is the strongest predictor of VT recurrence.', 'We sought to determine whether T-wave amplitude (TWa) in leads V2 and V3 after reperfusion in posterior MI (PMI) is greater than in patients without PMI.', 'The risk of AF recurrence after the ECV can be predicted by the P wave characteristics.', 'T-wave oversensing by an ICD can be a serious problem in some patients , causing overestimation of the heart rate , inappropriate tachyarrhythmia detection and therapy delivery .', 'We hypothesized that VT recurrence can be predicted and be related to the all-cause death after VT storm ablation guided by remote magnetic navigation (RMN) in patients with ICM.', 'Reperfusion of the posterior wall results in higher right precordial TWa, and an even greater increase in TWa, as measured in leads V2 and V3.']


Cluster  2044
['Erosive tooth wear is a serious problem with very costly consequences .', 'A serious drawback of veneering porcelains is a pronounced susceptibility to chipping .', 'Staining of the prostheses by foods , cosmetics , and tobacco is a serious problem .', 'The decalcification of enamel is a serious clinical problem in orthodontic patients and is usually observed as white spot lesions surrounding brackets .', 'Enamel hypoplasia is a common condition that may present a severe aesthetic problem .', 'Discoloration caused by staining of resin restorations can pose a serious esthetic problem .', 'Dentition discoloration due to intrinsic staining can be a severe esthetic problem .', 'Decalcification during orthodontic treatment is a serious problem .', 'Decalcification remains a serious problem when treating patients with a multibracket appliance .', 'Repairing porcelain restorations creates a serious dilemma for the restorative dentist .', 'Fractured porcelain poses a serious cosmetic and clinical problem .']


Cluster  1109
['Pollution of groundwater with chlorinated aliphatic hydrocarbons ( CAHs ) is a serious environmental problem which is threatening human health .', 'The appearance of pharmaceuticals in the aquatic environments has become a serious problem because of their hazardous effect on the biota .', 'The chronic exposure to the pharmaceuticals and personal care products contaminants in water represent a serious public health problem to man and animal .', 'The contamination of water by chlorinated solvents is recognized as a serious and widespread problem throughout the industrialized world .', 'Illicit drugs have been recently identified as a serious environmental problem because of the growing evidence regarding their occurrence in aquatic environment and potential toxicity towards non-target organisms .', 'The increasingly ubiquitous release of emerging refractory pollutants into water is a serious concern due to associated risks .', 'The presence of pharmaceuticals and personal care products ( PPCPs ) in natural water resources due to incomplete removal in Wastewater Treatment Plants ( WWTPs ) is a serious environmental concern at present .', 'The presence of emerging pollutants such as hazardous chemicals , pharmaceuticals , pesticides , and endocrine-disrupting chemicals in water sources is a serious concern to the environment and human health .', 'Increased consumption of pharmaceutical compounds compounded by their persistence in biological treatment processes and potential toxicity is becoming a serious concern .', 'Human pharmaceutical residues are a serious environmental concern .', 'Nowadays , contamination of wastewater with diclofenac and other pharmaceutical residues is becoming a severe problem .', 'Widespread use of tributyltin ( TBT ) poses a serious environmental problem .']


Cluster  2353
['Obesity is becoming a serious problem in disabled individuals .', 'Sedentary, overweight or obese middle-aged and older adults ( n = 7, 60.', 'Thirty-five overweight or obese volunteers with sedentary lifestyles aged 41.', 'Weight loss among older patients is a severe problem , associated with an increased incidence of infections , decubiti , and death .', 'Dietitians must be key participants in the effort to raise awareness of obesity as a serious health concern for older persons .', 'Age-related decreases in lean mass represent a serious health problem .']


Cluster  2063
['The problem of " just " wounded but not instantly killed animals while having an accident is pointed out as a severe problem from the animal welfare \'s point of view .', 'Most roadkilled species were common generalists , but there were also relatively high roadkill numbers of threatened and endangered species ( 4.3 % of the data ) , which is a serious conservation concern .', 'Wildlife-related accidents , especially deer-vehicle accidents , pose a serious problem for road safety and animal protection in many countries .', 'Wildlife mortality caused by vehicles is a serious conservation and economic problem as collisions with large mammals are global , pervasive and increasing .']


Cluster  1191
['This significantly compromises quality of life and may have immeasurable psychosocial and economic repercussions , constituting therefore , a serious public health problem requiring a targeted approach .', 'AN is a serious medical problem in young people in Western societies .', 'It is a challenge to physicians , a serious problem to patients and a human and financial loss to the community .', 'This is a serious problem which pervades community , acute and chronic care settings .', ', has become a serious global health problem with an enormous biomedical impact and diverse psychological and clinical manifestation .', 'The deinstitutionalization movement has given rise to an increasing number of young adult chronic patients in the community , a situation that poses a serious problem for both psychiatry and society .', 'This is a serious clinical problem and puts both those requiring care and those providing it at risk of adverse outcomes .', 'These " deinstitutionalized " patients cause a serious problem for the Health system .', 'This issue indicates a serious psychological , physical and social problem in community .', 'Providers need to prepare now for what is apt to be a serious financial , organizational , and emotional problem .']


Cluster  1084
['Retrospective study of the eligible population of the first round of the BCRCSP.', 'Among 1212 eligible callers, 709 (58.', 'We recruited 23 KTP recipients (September 2011 through May 2014).', 'In total, 1097 opportunities for donning PPE were observed.', 'PCV10-NVP began September 2010 with a 2\u2009+\u20091 schedule; uptake in 2012 was estimated at 92%.']


Cluster  667
['The conclusion is thus conditional : if we think the problem of naked statistical evidence is a serious problem in the legal domain , then we should be concerned about the symmetrical problem for PPPs .', '5 , if all of the a ; , are in A then so is at least one of the O. ; , -LRB- In fact , the other two conditions are just special cases of this condition . -RRB- the assertion component of the latter is essentially limited to atomic predications and their negations , so that ordinary statements such as Most students who passed the AI exam also passed the theory exam , or If Kim and Sandy get divorced , then Kim will probably get custody of their children , cannot be represented , let alone reasoned with', 'It is obvious that this dual question of true or false invokes the issue of vagueness', '5 , if all of the a ; , are in A then so is at least one of the O. ; , -LRB- In fact , the other two conditions are just special cases of this condition . -RRB- the assertion component of the latter is essentially limited to atomic predications and their negations , so that ordinary statements such as Most students who passed the AI exam also passed the theory exam , or If Kim and Sandy get divorced , then Kim will probably get custody of their children , cannot be represented , let alone reasoned with', 'If we want to be guaranteed a non-deficient joint interpretation , we can require equality . limited data']


Cluster  220
['The results show that following intake of 400 μg/day of folic acid, the risk of folate deficiency as seen in regular dietary intake disappears and the nutritional status of this nutrient is increased (p < 0.', 'After 3 months of treatment, the plasma Hcy levels of 484 patients were reduced to below the normal levels (15\xa0μmol/L), corresponding to an effective rate of 56.', 'A total of 858 patients with HHcy were treated with oral folic acid (5 mg/d) for 3 months.', 'This study showed that hyperhomocysteinemia independently elevated diastolic blood pressure (DBP) (β (SE): 2.', 'Our data suggest that hyperhomocysteinemia is not a serious clinical concern in epileptic patients when folate nutriture is adequate .', 'Given the results of our study, subsequent studies evaluating folic acid supplementation should also consider evaluating the status of B<sub>12</sub> and B<sub>6</sub> , and serum and RBC folate, as they participate interdependently in the cycle of folate and methionine and in homocysteine metabolism.', 'The present study aimed to investigate the effective rate of folic acid for the treatment of HHcy and the impact of plasma baseline Hcy levels and the compliance of oral folic acid on the efficacy.', 'The peak increase in 25OHD levels was reached after 90\xa0days of treatment in group 1 (59.', 'The present study demonstrated that the MTHFR A1298C mutation accompanied by hyperhomocysteinemia jointly elevated DBP.']


Cluster  1509
['However , high-dimensionality in PLV data incurs a serious multiple testing problem .', 'Collection of spatial signals in large numbers has become a routine task in multiple omicsfields, but parsing of these rich data sets still pose certain challenges', 'A problem with these signals is that comparison data that have the same size as the registration data must be acquired every time .', 'However , this method involves large-scale , high-resolution datasets , which impose a serious multiple testing problem .', 'However , the problem with genome scans involving thousands of markers is that the statistic values of FAs can reach quite extreme magnitudes .', 'A major drawback of RF signal processing to extract the target velocity is the large number of data points to consider .']


Cluster  2143
['Worldwide , out-of-hospital cardiac arrest ( OHCA ) remains a serious problem .', 'The purpose of the article is to investigate the association between the time spent in different MAP categories and ICU mortality in postcardiac arrest patients admitted to the ICU surviving ≥24\u2009h with vasopressor support.', 'This study suggests that maintaining a mean arterial pressure of equal or greater than 65 mmHg may be a reasonable target in postcardiac arrest patients admitted to the ICU with vasopressor support.', 'However , with the increasing age of patients , preexisting disease or trauma , and new surgical interventions cardiac arrests remain a serious concern .', 'We identified 31 admissions to the ICU following cardiac arrest due to ACS during the study period.', 'A significant proportion of patients admitted to the intensive care unit with a diagnosis of cardiac arrest secondary to acute coronary syndrome survive to hospital discharge with meaningful recovery in neurological and cardiac function.']


Cluster  1215
['Drug-induced liver injury ( DILI ) , which is caused by drugs and herbal or dietary supplements , remains a serious concern for drug developers , regulators , and clinicians ; however , serum biomarkers utilized to detect and monitor DILI have not changed in decades and have limitations .', 'Hepatotoxicity and acute liver failure caused by an acetaminophen overdose is a serious clinical problem in western countries .', 'Drug-induced liver injury ( DILI ) is a serious problem in pre-clinical stages of drug development and clinical pharmacotherapy , but the pathogenesis of DILI has not been elucidated .', 'Drug-induced liver injury has become a serious public health problem .', 'Drug-induced liver injury ( DILI ) is a serious concern during drug development and the treatment of human disease .', 'Drug-induced liver injury has become a serious public health problem that can not be ignored .', 'Drug-induced liver injury ( DILI ) is a severe adverse drug reaction which is of major concern to patients , clinicians and the pharmaceutical industry .', 'In current scenario of human health and diseases , drug-induced hepatic injury has been recognized as a serious and unresolved problem .', 'Idiosyncratic drug-induced liver injury ( iDILI ) is a frequent cause of acute liver injury and a serious problem in late stage drug-development .', 'Despite growing research , drug-induced liver injury ( DILI ) remains a serious issue of increasing importance to the medical community that challenges health systems , pharmaceutical industries and drug regulatory agencies .', 'Drug-induced liver injury has become a serious health problem in contemporary society .', 'Idiosyncratic drug-induced liver injury ( iDILI ) is a serious concern in drug development .']


Cluster  751
['Rising ROS and systemic inflammation is often a serious concern in many disease conditions including obesity .', 'Abdominal obesity (AO) is associated with increased risk for cardiovascular disease and with increased production of adhesion molecules.', 'The pathways of chronic inflammation are well illustrated by nonalcoholic steatohepatitis ( NASH ) , which is of a serious concern due to its increasing prevalence in the westernized world and its direct correlation with lifestyle factors , particularly diet .', 'Obesity is a serious health problem and critically related to poor prognosis in cancer , presumably through induction of chronic inflammation .', 'A global increase in the prevalence of metabolic syndromes and digestive tract disorders , like food allergy or inflammatory bowel disease ( IBD ) , has become a severe problem in the modern world .', 'SSFN may be a serious factor in observations of impaired wound healing among obese subjects , a particularly worrisome problem in an obese aging population given the propensity for small fiber impairment in aging subjects .', 'Proximal occlusion of the LSA was independently related to elevated triglyceride and white blood cell counts.', 'This study aims to accomplish a macroscopic morphometry evaluation on diabetic ulcer area in humans that were under PDT.', 'Colitis is a serious health problem , and chronic obesity is associated with the progression of colitis .']


Cluster  2356
['This type of organized screening represents a significant preventative effort in the construction industry, as workers may become more cognizant of the conditions that may affect their work ability.', 'In this randomized controlled study involving 3 waves of data collection, 140 construction trade artisans who presented with high occupational stress symptoms at the study onset were assigned randomly to either a treatment condition (n\u200a=\u200a70) or to a waitlist control condition (n\u200a=\u200a70).', 'There was a physical effort during the activity and a high prevalence of workers with pain complaints, which justifies the investigation.', 'Cognitive behavioral intervention effectively reduced occupational stress symptoms and dysfunctional thoughts at work among Nigerian construction trade artisans compared with a waitlist control condition.', 'To determine the number and age of construction workers in Croatia with temporary or permanent work limitation status, as well as to identify the most common health causes of such work limitation.', 'Maintaining adequate working ability of construction workers is of considerable importance for society, as the construction sector is burdened with high prevalence of work-related diseases and health-issues.', 'A retrospective cross-sectional study was performed using the data from 2534 construction workers, aged between 18 and 65 years, who underwent standardized routine occupational health examinations between 2011 and 2015.']


Cluster  296
['Acute liver failure is a severe liver disorder that poses considerable global challenges .', 'Acute fulminant liver failure is a serious worldwide health problem .', 'Acute liver failure (ALF) is defined as acute liver injury (ALI) associated with coagulopathy.', 'Acute liver failure ( ALF ) remains a serious problem in critical care with a high rate of mortality .', 'End-stage organ failure is a devastating problem with limited therapeutic options .', 'Acute liver failure is a serious clinical problem of which the underlying pathogenesis remains unclear and for which effective therapies are lacking .', 'The problem with any attempt to feed patients in multiple organ failure is that , because of an ongoing inflammatory process , the conventional techniques of supplying energy and protein do not maintain lean tissue mass .', 'Prolonged support of organ functions without therapeutic benefit represents a serious problem of therapy in intensive care units ( ICUs ) .']


Cluster  1950
['Traumatic carotid artery dissection , if not diagnosed and treated early , is a serious problem with permanent neurological deficit and a high mortality rate of up to 40 % .', 'Acute brain injury , such as intracerebral hemorrhage is a serious problem .', 'Although bleeding is a serious and potentially fatal complication of these injuries , the main concern should be the impairment of cerebral blood supply .', 'Acute cerebrovascular disease is a serious neurological problem .', 'Cerebrovascular accident is a serious public health problem and requires the attention of professionals who can detect , diagnose , and provide care in a timely fashion .', 'Neurological complications represent a serious problem and their incidence rate is hard to reduce .', 'Brain injury is a devastating medical condition and represents a major health problem .', 'CNS injuries represent a serious public health problem , despite improvements in therapeutic management .', 'Neurotrauma or injuries to the central nervous system ( CNS ) are a serious public health problem worldwide .']


Cluster  2032
['Lidocaine infusion therapy (3 mg/kg of lidocaine administered over 1 hour) provided effective short-term pain relief, which was substantially prominent after repeated infusions were administered to patients with refractory NeP.', 'Results were consistent with the hypothesis that needle-free injection of lidocaine is an effective therapy for the management of pain in children between the ages of 3-16 years who receive an IV.', 'Three hundred eighteen patients with tumors on the head and neck were injected with lidocaine using a previously described technique with either a 30- or 33-gauge needle.', 'The result of this study demonstrated that, granisetron reduces pain on injection of etomidate more efficiently than lidocaine.', 'Lidocaine infusion therapy (LIT) is an effective treatment for relieving neuropathic pain (NeP).', 'Bilateral paravertebral infusion of lidocaine confers no advantage over systemic lidocaine infusion after cardiac surgery.', 'Injection with lidocaine heated to around body temperature was less painful than injection with lidocaine at room temperature.', 'Intraoperative infusion of lidocaine significantly decreases the proportion of patients with acute pain after supratentorial tumor surgery in the PACU.']


Cluster  1334
['Due to the high prevalence of cardiovascular disease in the population , even a modest causal association with ETS would , if valid , constitute a serious public health problem .', 'An additional problem with using absolute risk is that the risk of atherosclerotic disease accumulates over time .', 'Thus the possibility of dose-related bias in case detection was a serious concern .', 'In particular , the human factor is considered to be a serious problem in ATC safety and has been identified as a causal factor in both major and minor incidents .', 'Due to its long-term metabolic and cardiovascular consequences , it poses a severe health problem .', 'The exposure levels to risk factors were identified as a serious problem .', 'However , potential metabolic consequences remain a serious problem .']


Cluster  2386
['The recent increase of the number of unidentified cadavers has become a serious problem throughout the world .', 'There is clearly a need for public educational efforts with regard to organ donation.', 'The introduction of a new communication approach between medical staff and relatives of brain-dead patients was associated with a significant increase in the rate of consent to donation.']


Cluster  1769
['The present study demonstrated a strong correlation between A-LACT and V-LACT, but an agreement between both parameters was poor.', 'The mean difference (PV-LACT-A-LACT) is 0.', 'Equation 3 ensures that A is nonnegative . such probabilities could not be estimated directly from the data due to data sparseness', 'The minimum cross-sectional area (p < 0.']


Cluster  612
['Hemolysis due to ineffective erythropoiesis is a serious problem β-thalassemia major ( β-TM ) patients .', 'Since haemoglobin D and S are indistinguishable by most common conventional methods , the geographical coincidence of the two haemoglobin poses a serious screening problem which was investigated in the propositus who is heterozygous for S and D , his wife who is heterozygous for A and S , and their six children .', 'Thalassemias are the most frequent monogenic disorders around the world and are a serious health problem in areas with a high incidence .', 'Hemoglobinopathies are common inherited monogenic diseases that are likely to remain a serious regional health problem where thalassemias and sickle cell disease are prevalent .', 'The thalassemias and other inherited disorders of hemoglobin are likely to remain a serious global health problem for the foreseeable future .', 'A serious problem in thalassemia major is growth impairment for which several possible etiologies have been proposed .', 'Homozygosity for the alpha(0)-thalassemia deletion ( --/-- ) is a serious health problem in Southeast Asia and the Philippines and is responsible for the majority of hydrops fetalis in this region .', 'This cross-sectional study was conducted on 108 patients with Beta-thalassemia intermediate who referred to tertiary hospital, Shiraz, Iran.', 'Despite recent progress in iron chelation therapy , sudden cardiac death due to malignant ventricular arrhythmias remains a vexing , clinical problem in patients with beta-thalassemia major ( TM ) .', 'Our study suggests that genetic discrimination is already a serious problem and that any proposed screening program for hemochromatosis or other genetic condition must consider and attempt to mitigate its effects .', 'A case-control study was conducted on 50 β-thalassemia patients (10 patients with thalassemia minor, 30 patients with thalassemia major, and 10 patients with thalassemia intermedia, with 10 normal adult volunteers as a control) from June 2016 to March 2017.', 'Certain hemostatic anomalies found in patients with thalassemia suggest the existence of a chronic hypercoagulable state.']


Cluster  2065
['A total of 12 patients (7.', 'Of patients, 57.', 'A total of 68 patients (13.', 'Twenty-seven patients, 48.', 'A total of 83 patients (56.', 'One hundred seventy-seven patients (87.', 'Fifty-one patients, 37 men (72.', 'Eighty-four patients (40 (47.', 'Seven patients (20.', 'A total of 123 patients (51.', 'Twenty-five patients (37.', 'A total of 3913 patients (67.']


Cluster  1067
['To investigate the effect of kinesiotape on women with postnatal backache.', 'To assess the effects of two exercise protocols (stabilization vs movement control) on pain and disability scores and the flexion relaxation ratio (FRR) of lumbar multifidus (LM) and iliocostalis lumbarum pars thoracic (ICLT) in people with extension related non-specific chronic low back pain.', 'Twelve weeks of BodyPump, heavy load resistance training with a personal trainer and non-supervised heavy load resistance training did not show any effect on self-reported musculoskeletal pain in overweight women.', 'An assessment of the effects of a 12-week Nordic Walking training program on the perceived pain threshold (PPT) and the flexibility of selected upper-body muscle groups in postmenopausal female office workers.', 'We aim to compare the effectiveness of 3 active interventions, i.e., yoga, eurythmy therapy, and physiotherapeutic exercise, on chronic lower back pain.', 'The present study aimed to investigate between group differences in musculoskeletal pain in previously inactive women, allocated to three different resistance-training modalities available in health- and fitness clubs.', "Kinesiotape and postural correction exercises can be recommended as effective treatment methods for women's postnatal back pain with better effect of kinesiotape and postural correction exercises than exercise alone."]


Cluster  1265
['Minor complications were more prevalent in octogenarians (P = .', 'Frailty phenotype at admission is common among elderly patients with ACS and is an independent predictor for severe adverse events.', 'We conclude that HCAIs are a serious health problem in German nursing home residents .', 'In addition , the advanced age and frail nature of patients with AD mean that poor tolerability is a serious concern .', 'One-hundred twenty-nine elderly patients with aMCI diagnosis (mean age 66.', 'Among 822 older patients with AMS, infection (39.', 'This retrospective 2-year service evaluation included first emergency admissions of any older adult (≥75 years) presenting to Cambridge University Hospital.', 'In a\xa0retrospective observational study, we evaluated the prevalence of NI during hospitalization of acute geriatric inpatients of the geriatric department at Jena University Hospital by patient records.']


Cluster  1308
['Latex allergy is a serious occupational health problem among medical workers , but there are few data regarding its incidence and clinical characteristics in Taiwan .', 'In the past decade , immediate hypersensitivity to latex has been accepted as a serious problem .', 'Natural rubber latex allergy is a serious medical problem for a growing number of patients and a disabling occupational disease among health care workers .', "Latex allergy may not be as prevalent as we think , but it 's still a serious problem that affects patients and healthcare workers alike . You can minimize its effects by knowing who 's at risk , how it 's diagnosed , and how to reduce the amount of latex in your workplace .", 'This has lead to recognition of latex allergy as a serious medical concern .', 'Although latex products have been in use for over a century , allergic responses to latex proteins have only been recognized as a serious health problem for the past 15 years .', 'Latex allergy is a serious problem for health care providers and the general public .', 'Latex allergy is a serious medical problem for an increasing number of patients and health care workers .', 'Medical devices manufactured from latex pose a serious problem because of the risk of induction of allergy both against the latex proteins inherently present ( type I or immediate type allergy ) and against chemicals added during processing ( type IV or delayed type hypersensitivity ) present as residues in the latex products .', 'Latex allergy currently constitutes a serious problem because of the severity of its symptoms and the at-risk groups it affects .', 'Natural rubber latex allergy is a serious medical problem for a growing number of patients and a disabling occupational disease among health care workers .', 'Natural latex gloves are the cause of a severe health problem to an increasing number of healthcare workers or patients due to the presence of protein allergens as Hevein or Rubber Elongation Factor ( REF ) .']


Cluster  92
['All groups demonstrated a statistically ( P < .', 'The experimental group showed statistically significant results in all dependent variables week four compared to the control group.', 'A statistically significant decrease in the relative amount of arachidonic acid (P < 0.', 'In between groups, comparison showed statistically significant differences between all groups (p\xa0<\xa00.', 'Statistical significance was observed in the percentages of hypertension (P = 0.', 'A statistically significant increase in weight (1.', 'The mixed model ANOVAs showed significant side by time interaction (p\xa0<\xa00.', 'A significantly increase (P<0.', 'There was a significant difference in the incidence of arrhythmia between two groups (P = 0.', 'No significant differences (p\u2009>\u2009.', 'We found a difference of 17 mm (95% CI, 4-31 mm; P < 0.', 'There was significant difference in one-to-one correspondence (p\xa0= 0.', 'Ex vivo, GS significantly (all p ≤ 0.', "Using a repeated measures one-way MANOVA, there was a statistically significance difference between intervention and control groups Wilk's ∧\xa0=\xa00.", 'Both the groups showed statistically significant improvements in all the study parameters at the end of study period (P < 0.', 'Significant differences (p<0.', 'When compared to the general average of the concentrations of each group, significant values (p <0.', 'There was a significant increase (p<0.', 'The re-donation rates among the three groups were statistically significantly different (P = 0.', 'There was a difference between CE (p<0.', 'VAS score showed significantly (p\u2009<\u20090.', 'Significant differences were observed in HR (P\u200a<\u200a.', 'Only sensitivity showed statistical difference (P < 0.', 'The high-weight-loss group demonstrated increased ( p = 0.', 'A significant difference (p< 0.', 'In this study, there was no significant difference between two groups according to VAS in onset (p\u2009=\u2009.']


Cluster  898
['Healthy students and members of staff of Obafemi Awolowo Teaching Hospitals Complex, Ile-Ife, South West Nigeria, free of obvious ocular diseases except possible refractive errors were recruited.', 'This prospective, interventional, randomized clinical study was done at Alpha Vision Center, Zagazig, Egypt.', 'Observational study that took place in a pediatric ophthalmology department, Paris, France.', 'Thirteen patients with presbyopia (aged between 45 and 60\u2005years) received successive randomised presbyopia compensation with contact lenses supplying monovision (one eye corrected for distance, the other for near vision) and simultaneous vision (progressive lenses).', 'Thirty-seven eyes were enrolled in group 1 (no GFS) and 23 eyes were enrolled in group 2 (failed GFS).', 'This paper is a cross-sectional observational study of 22 eyes of 11 patients (mean age 23.', 'Computer vision syndrome prevalence , knowledge and associated factors among Saudi Arabia University Students : Is it a serious problem ?', 'At the last visit, the mean intraocular pressure for the temporal group was 17.', 'The purpose of the current study was to evaluate the effects of filtering by an activated photochromic lens on visual performance in healthy adults.', 'Fifty-eight eyes were analyzed.', 'In the cornea, mean and standard error of the mean LCD was greater after one week of lens wear in CLIDE (55 ± 7 cells/mm<sup>2</sup> ) versus NO-CLIDE (43 ± 4 cells/mm<sup>2</sup> ) (p = 0.', 'The temporal and inferior quadrants are preferential sides for lens decentration, which was associated with the occurrence of complications such as ghosting and corneal epithelial staining.', 'Twenty-five participants with contact lens-induced dry eye (CLIDE) and 35 without CLIDE (NO-CLIDE), diagnosed using a range of symptom questionnaires and objective tests (tear film break up, cotton thread tear test and corneal staining) were enrolled.', 'A prospective, observational, cross-sectional study was performed in the outpatient ophthalmology clinic.', 'Patients were divided into control (lens without clinical phacodonesis) and study (lens with suspicious and clinical phacodonesis) groups for evaluation.', 'The sum of pretreatment corneal Q-value differences between nasal-temporal and superior-inferior quadrants is a convenient and reliable predictor for orthokeratology lens decentration.']


Cluster  1487
['To verify if such effects occur in participants with medial knee osteoarthritis.', 'The study of exercise adherence during an arthritis flare is recommended by arthritis researchers.', 'In this single-blinded, randomized clinical trial, 90 patients with osteoarthritis of the knee who referred to the outpatient rheumatology clinics affiliated with Birjand University of Medical Sciences were selected through convenience sampling method.', 'To investigate the immediate effect of a patellar tendon strap on weight-bearing asymmetry during squatting in people with unilateral knee osteoarthritis.', 'Thirty two women with knee OA, aged 50-70 years, with overweight or obesity grade I, who were randomized into two groups: one with exercise and KT, and the other, with exercise and placebo technique.', 'The study was conducted with 80 patients with knee osteoarthritis.', 'Data from 97 individuals with knee osteoarthritis who participated in a randomized clinical trial examining effects of a 12-week quadriceps strengthening program was used to conduct this secondary exploratory analysis.', 'Thirty participants with patellar tendinopathy and 30 controls participated.', 'Forty knee OA patients with cartilage classifications of Outerbridge grade II, III, or II plus III determined via arthroscopy were randomly assigned to a treatment of liver-softening medicine plus glucosamine or a control treatment of glucosamine alone.', 'Early identification of knee osteoarthritis (OA) can improve treatment outcomes and reduce medical costs', 'Patellar tendon straps reduced pain in those with patellar tendinopathy.', 'Evaluate the effect of a 12week lower body positive pressure (LBPP) supported low-load treadmill walking program on knee pain, joint function, and performance of daily activities in patients with knee osteoarthritis (OA).']


Cluster  1852
['In a cohort of 241 uncomplicated pregnancies, we investigated the immunogenicity of HPA mismatches and correlated HLA sensitization with HPA antibody formation.', 'This study aimed to determine human neutrophil antigen (HNA) frequency, estimate possible HNA incompatibilities and predict the risk of HNA alloimmunisation in the Northeastern Thai, Burmese and Karen populations.', 'Among LBW infants, GA, IL-6, erythropoietin, and soluble transferrin receptor were associated with Hep25 levels.', 'Our observational data indicated a low immunogenicity of HPA and suggest that a broader immune response-inferred by HLA sensitization-is probably associated with HPA antibody induction.', 'The frequencies of HPA genotypes in our study indicates that HPA-1a, -2a, -4a, -5a and -6a are unlikely involved in FNAIT, PTP and PTR in Burmese and Karen populations.', 'Th17-type responses are amplified in preterm neonates exposed to HCA.', 'In this cohort, HNA-1a was more prevalent than HNA-1b.', 'Six females with HAE type I and a median age of 10.']


Cluster  660
['Anemia is a serious problem in the fetus and preterm infant .', 'Anemia is a serious public health concern especially in women of reproductive age ( WRA ) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle .', 'Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough ( 63.1 % ) to be described as a severe public health problem .', 'Low Haemoglobin concentration ( Hb ) among women of reproductive age is a severe public health problem in sub-Saharan Africa .', 'Anemia during pregnancy is a serious public health problem .', 'Anemia is a serious problem in critically ill neonates .', 'However , anaemia in the third trimester is still a severe public health problem among pregnant women in these areas .', 'Although it has declined in the past 13 years , anemia in women of childbearing age remains as a serious public health problem .', 'Determine the incidence and perinatal risk factors associated with postpartum anaemia in women who gave birth vaginally.', 'Postpartum anaemia has a high incidence.', 'The prevalence of anemia is a severe public health problem among pregnant women of underprivileged ethnic groups in Province 2 .', 'The high prevalence of anemia and underweight among reproductive age women is a serious health concern in Nepal .']


Cluster  930
['Despite widespread recognition of child sexual abuse as a serious problem in sub-Saharan Africa , few far-reaching programmatic interventions addressing child sexual abuse in this setting are currently available , and those interventions that do exist tend to focus on response rather than prevention .', 'International sex trafficking into the United States appears to be a serious and growing problem , although the evidence regarding prevalence , risk , and consequences is incomplete .', 'Commercial sexual exploitation of children ( CSEC ) and adolescents is a serious worldwide problem .', 'Adolescent sexting is a serious public health concern and is associated with adverse psychosocial outcomes , including depression , anxiety , low self-esteem , declining academic performance , and health problems .', 'This is a serious problem , but one that requires approaches different from those in current prevention messages emphasizing parental control and the dangers of divulging personal information .', 'A major drawback of research on sexual behaviour in Africa is the separation between theories and empirical work .', 'Commercial sexual exploitation and sex trafficking of children and adolescents represent a severe form of child abuse and an important pediatric health concern .']


Cluster  1352
['Teen dating violence is a serious public health problem .', 'Dating violence is a serious and prevalent problem , with females being victimized by partners at high rates with numerous negative health consequences .', 'Physical dating violence ( PDV ) victimization among adolescents is a serious global problem .', 'Violence in dating relationships constitutes a serious problem , thus , the study of related factors could help to better understand this violence and intervene in it .', 'The main aim of this study was to analyse the psychometric properties of the Spanish version of the Acceptance of Dating Violence (ADV) scale, which assesses attitudes that justify the use of aggression in adolescents&rsquo; dating relationships', 'Dating violence (DV) is still a global problem of enormous proportions', 'Dating violence is a serious and prevalent public health problem that is associated with numerous negative physical and psychological health outcomes , and yet there has been limited evaluation of prevention programs on college campuses .', 'Dating violence ( DV ) is a serious problem with devastating consequences .', 'Dating violence is a serious problem among adolescents and young adults .', 'Teen dating violence ( TDV ) is a serious and prevalent public health problem .']


Cluster  729
['Introduction HIV infection continues to be a serious health concern globally .', 'The present paper provides an account of the results of ongoing comprehensive studies conducted in the north-eastern states of India on drug-related HIV infection , already a serious problem , but possibly still restricted to that region of the country .', 'HIV infection is common and a severe problem in Thailand .', 'In spite of all the efforts that has been made in prevention and the success of   antiretroviral therapy ( ART ) , AIDS remains a serious public health problem .', 'The HIV infection remains a serious public health concern in France and around the world .', 'Human immunodeficiency virus type 1 ( HIV-1 ) infection remains a severe public health problem worldwide .', 'Human immunodeficiency virus ( HIV ) is still a serious global health concern responsible for more than 25 million deaths in last three decades .', 'Data from 1429 men and women aged 50 years or older living in two slum areas of Nairobi are used to compare AIDS-caregivers with other caregivers and non-caregivers based on self-reported health using the World Health Organization disability assessment ( WHODAS ) score and the presence of a severe health problem .', 'Water insecurity ( WI ) is a serious and worsening problem worldwide , but its role in health outcomes among people living with HIV or pregnant women is unknown .', 'Human immunodeficiency virus ( HIV ) is a serious health problem in the Russian Federation .', 'Injecting Drug Users ( IDUs ) have become a serious concern in public health due to their potential in HIV transmission .', 'Human immunodeficiency virus ( HIV ) infection remains a serious problem in northern Thailand .', 'HIV infection and the AIDS epidemic in Cambodia have become a serious problem and patients urgently need adequate diagnosis and antiretroviral therapies .', 'HIV infection rates in the developing world remain a serious problem .', 'Despite its importance in HIV/AIDS prevention and treatment , HIV/AIDS Counseling and Testing ( HCT ) is low in sub-Saharan Africa , where the disease continues to be a serious public health problem .', 'This situation poses a serious problem for low income countries , especially those with a high prevalence of human immunodeficiency virus type 1 ( HIV-1 ) infection .', 'Despite advances in treatment and prevention , HIV/AIDS remains a serious health and social problem .', 'A vaccine could substantially impact the HIV epidemic , but inadequate uptake is a serious concern .', 'Potential bridging of HIV transmission from IDU to non-IDU populations is a serious concern .', 'The HIV-1 epidemic in India is still growing with introduction of new strains/subtypes and this creates a serious problem for the clinician and basic science researchers to find the effective measures .', 'Antiretroviral resistance has long been a serious problem in Thailand .', 'HIV continues to be a serious public health problem for men who have sex with women ( MSW ) , especially homeless MSW .', 'The increase in human immunodeficiency virus ( HIV ) transmission cases poses a serious public health concern .', 'Washington , DC , is a metropolitan city with a severe HIV epidemic and faces challenges in retaining people living with HIV ( PLWH ) in quality care .', 'AIDs are a serious public health problem worldwide .']


Cluster  1466
['However , the nephrotoxicity induced by FK506 remains a serious clinical problem .', 'In fact , drug-induced kidney injury is a serious problem in clinical practice and accounts for roughly 20 % of cases of acute kidney injury ( AKI ) among hospitalized patients .', 'Drug nephrotoxicity is a serious health and economic problem worldwide .', 'Idiosyncratic drug reactions represent a serious health problem , and they remain unpredictable largely due to our limited understanding of the mechanisms involved .', 'Nephrotoxicity induced by antimicrobial or anticancer drugs is a serious clinical problem .', 'Drug-induced acute kidney injury is a serious problem in drug development and clinical treatment .', 'Drug-induced toxicity , which impairs human organ function , is a serious problem during drug development that hinders the clinical use of many marketed drugs , and the underlying mechanisms are complicated .']


Cluster  1529
['His work has led to the acceptance of caffeine as a standard treatment of apnea in premature infants , and his current studies of ibuprofen as a possible treatment of cerebral intraventricular hemorrhage , a serious problem in some premature babies , have yielded promising results .', 'Posthaemorrhagic ventricular dilation following intraventricular haemorrhage is a serious problem with high morbidity in preterm babies .', 'Germinal matrix-intraventricular haemorrhage ( GMH-IVH ) remains a serious problem in the very and extremely preterm infant .', 'In patients with hypertensive intracerebral hemorrhage (HICH), intravenous nicardipine is primarily used to lower blood pressure (BP).', 'Although the percentage of small preterm infants developing intraventricular haemorrhage ( IVH ) has been greatly reduced in the last three decades , increased survival of very immature infants has meant that large IVH with subsequent posthaemorrhagic ventricular dilatation is still a serious unsolved problem .']


Cluster  571
['A major drawback of therapy with ATO is the development of APL cell resistance , the mechanisms of which are still not clear .', 'All-trans retinoic acid ( RA ) resistance in acute promyelocytic leukemia ( APL ) has been a serious clinical problem in differentiation-inducing therapy .', 'Though , little is known about the effects of arsenical on leukemia resistant to chemotherapy , emerging as a serious clinical problem .', 'However , little is known about the effects of GLA on leukemia resistant to chemotherapy , emerging as a serious clinical problem .', 'Therapy-related leukemia or myelodysplasia ( t-leuk/MDS ) is a serious problem that is increasing in frequency .', 'Therapy of leukemia in infants remains a serious problem and warrants further studies to establish the best approach .', 'Acute myeloid leukemia ( AML ) in the elderly is a serious problem characterized by poor response to therapy and short survival .', 'Therapy-associated hematologic neoplasias are a severe medical problem due to the high incidence of breast cancer and the dismal outcome of secondary leukemias , which occur in 0.3 - 5 % of patients receiving antineoplastic therapy .', 'The introduction of all-trans retinoic acid ( ATRA ) into anthracycline-based induction chemotherapy regimens has dramatically improved overall survival of individuals with APL , although hemorrhage-related death during the early phase of therapy remains a serious problem .', 'Patients with initially diagnosed acute myeloid (AML) or lymphocytic (ALL) leukemia and a matched healthy control (HC) group were included.', 'Retinoic acid ( RA ) resistance is a serious problem for patients with acute promyelocytic leukemia ( APL ) who are receiving all-trans RA .', 'RA is available for the treatment of acute promyeloleukemia , although the development of resistance to the agent is a serious problem for differentiation-inducing therapy .']


Cluster  649
['Semiskeletonized ITA resulted in superior DF of left anterior descending bypass graft flow as compared with pedicled ITA.', 'Graft failure or progressive native vessel disease can be a serious problem after coronary artery bypass grafting .', 'Data were collected prospectively from 50 patients undergoing cardiac surgery on cardiopulmonary bypass over a 6-month period.', 'Historical cohort study with adult patients who underwent coronary artery bypass grafting.', 'Vein graft disease is a major drawback of coronary artery bypass grafting .', 'In this report we discuss the incidence of surgically induced distal target vessel stenosis in patients who undergo the minimally invasive coronary artery bypass grafting procedure , which represents a major drawback of the procedure in our experience .', 'Harvest site infections after coronary artery bypass grafting ( CABG ) are a known complication which represent a serious problem for patients and an increased cost of health care .', 'In this randomized trial, 87 patients undergoing elective and isolated coronary bypass surgery included.', 'Between July 2015 and May 2016, a prospective evaluation of 60 consecutive patients undergoing coronary artery bypass grafting for left anterior descending artery revascularization were randomized to having semiskeletonized (n\u2009=\u200930) or conventional pedicled (n\u2009=\u200930) ITA graft harvested by the same surgeon.', 'Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with cardiopulmonary bypass were enrolled in this prospective observational study.', 'The self-designed b-NPWT can effectively reduce postoperative complications, such as lymphedema, incision infection, wound dehiscence, and skin flap necrosis, in CABG patients who underwent great saphenous veins harvesting.']


Cluster  2118
['The insertion success rate was significantly higher in Group M than Group C (94% vs.', 'Group L had a higher success rate on first insertion and overall success rate than group C (p\xa0<\xa0.', 'The insertion time was significantly shorter in the TD group than in the D and I groups (23.', 'Immediate-loaded group showed the lowest ISQ values, 1 month after placement.']


Cluster  38
["Most practicing cardiologists were cautious about outpatient dofetilide use and adhered to the manufacturer's in-patient dofetilide protocol during de-novo initiation and reported low incidence of TdP in clinical practice.", 'Recurrence of SBP was significantly lower in the rifaximin group (3.', 'The mean C <sub>max</sub> following a repeated dose of liposomal bupivacaine remained well below accepted values for central nervous system and cardiac toxicity.', 'Atropine is significantly effective in the prevention of all types of vasovagal responses induced by CB ablation in patients with atrial fibrillation.', 'Diastolic BP was lower after compared to that before using tadalafil, but the difference was not significant.', 'Transient hypotension after infusion of amrinone was a serious clinical problem .', 'BACKGROUND : The tendency for the electrophysiologic effect of class III antiarrhythmic agents ( action potential prolongation ) to be diminished at faster heart rates represents a major drawback of this class of drug and is usually referred to as " reverse use dependence . " A novel class III agent , MS-551 , has recently been reported to exhibit less reverse use dependence than E-4031 .', "An observational survey was performed including 347 cardiologists in the United States and worldwide to evaluate the deviations from approved manufacturer's protocol during dofetilide initiation and re-initiation among practicing cardiologists.", 'The interim results showed safety consistent with the known profile of ambrisentan in terms of the types and frequencies of ADRs in patients with PAH in real clinical practice, in comparison with previous clinical trials in Japan and the rest of the world.', 'This randomized trial shows that ODF combination of perindropil, indapamide and amlodipine is as safe as free combination of the 3 drugs, but is associated with a greater efficacy in BP control, compliance and, associated with statin, in cholesterol reduction.', 'The mean arterial pressure was significantly higher in the midodrine and rifaximin group (P=0.', 'The two different baclofen 10-mg formulations had similar PK profiles and were bioequivalent based on C<sub>max</sub> and AUC<sub>last</sub>.', 'Daridorexant does not impair cardiac repolarization evidenced by absence of relevant QT prolongation at therapeutic and supratherapeutic doses.', 'We demonstrated that ivabradine significantly decreased ventricular rate during AF compared to placebo.', 'To our knowledge , this is the first time a severe heart conduction problem was induced in a spinal cord injury patient after a single therapeutic dose of Baclofen .', 'Only a slight difference in mean maximal systolic arterial pressure was detected between patients with or without an α-receptor blockade.', 'Rifaximin was more effective than norfloxacin in the secondary prevention of SBP.']


Cluster  1213
['Nowadays however , most large companies employ the statistical translation approach , using exceedingly large amounts of bilingual data -LRB- aligned sentences in two languages -RRB- . Mongolian uses the Cyrillic alphabet to represent both conventional words and loanwords , and so the automatic extraction of loanwords is difficult', 'Nowadays however , most large companies employ the statistical translation approach , using exceedingly large amounts of bilingual data -LRB- aligned sentences in two languages -RRB- . Mongolian uses the Cyrillic alphabet to represent both conventional words and loanwords , and so the automatic extraction of loanwords is difficult', 'Nowadays however , most large companies employ the statistical translation approach , using exceedingly large amounts of bilingual data -LRB- aligned sentences in two languages -RRB- . Mongolian uses the Cyrillic alphabet to represent both conventional words and loanwords , and so the automatic extraction of loanwords is difficult']


Cluster  1292
['Single day protocol for MAL-PDT for sBCC is feasible and this study shows promising results.', 'To address this concern , a sequential MTS was proposed , but it has the drawback of an increase of the number of possible MTSs as Nt becomes random .', 'The only drawback or risk of this strategy is that some of the system timex-values could be incorrect', 'A disadvantage of TNF is that it re-attaches a single node in every iteration', 'Our results suggest that tDCS over M1 might not have a predictable or reliable effect on short duration smRT.']


Cluster  599
['The problem in the treatment of patients with recurrent cancer is that there are two or more lesions in most instances and that cancer invasion is usually deeper .', 'However , secondary cancer , especially leukemias arising among the survivors and threatening their lives , has become a serious problem .', 'The development of second malignancies in patients cured of their primary cancer remains a distressing problem .', 'The proportion of ACS substantially increased in very late TLR lesions (57.', 'While the overall five-year survival was 42 % , late recurrences constitute a serious problem with eventual demise of about half of these patients .', 'The risk of local recurrence is still a serious problem with an incidence of between 15 and 45 % .', 'However , the development of malignancies after transplantation is a serious problem .', 'However , the high frequency of local recurrence after piecemeal EMR for large lesions is considered a serious problem .', 'Although microsurgery has considerably improved post-operative results , multifocal tumour development and recurrence remain a serious problem in the clinical management of HLS gene carriers .', 'A serious concern , however , is the fact that these patients subsequently develop second primary tumors at an annual rate of 4%-7 % .']


Cluster  1082
['Insufficient adherence of patients to treatment is a serious problem and it is monitored most frequently in hypertensive patients .', 'Despite the importance of adherence , medication nonadherence is a serious problem , with the World Health Organization noting that the average nonadherence rate is 50 % among those with chronic illnesses .', 'Medication nonadherence is a serious public health concern .', 'Nonadherence in children who use long-term medication is a serious problem and assessing adherence is an important step to provide solutions to this problem .', "Poor adherence to medical regimens is a serious problem that interferes with heart failure ( HF ) patients ' disease management and contributes to poor clinical outcomes .", 'Poor adherence with prescription medications is a serious problem in health care , especially true for patients with chronic diseases .', 'BACKGROUND Subcutaneous immunotherapy ( SCIT ) in allergic rhinitis ( AR ) and asthma is a very effective treatment , but adherence is still a serious problem .', 'Non-adherence to cardiovascular medications is a serious problem in the aging Australian setting with an overall prevalence of between 14 and 43 \xa0 % .', 'Suboptimal medication adherence is a serious problem in the treatment of chronic inflammatory diseases .', 'Adherence telemonitoring was acceptable to most patients with HF.', 'Failure to intensify therapy when indicated is a serious problem in the management of hypertension .', 'The present study will investigate whether a clinical decision support system integrated in an electronic health record can increase adherence to guidelines regarding anticoagulant therapy in patients with AF.']


Cluster  234
['A perceived problem with this approach is that the number of non-replicating viruses used as a vaccine inoculum does not remotely approximate the total number of cells in the body , nor even the number of tumour cells in the case of large tumour burden or metastasis .', 'In addition , a major drawback of biopharmaceuticals is the risk of antibody formation .', 'Unfortunately , protection is raised against a limited number of pneumococcal serotypes , and serotype replacement and subsequent vaccine failure have become a serious concern .', 'However , severe immune responses especially to the liver have been a serious problem of this vector .', 'A drawback of using free virus is that it gives a potent immune response , which reduces gene transfer and limits re-administration .', 'Pathogens that consist of multiple antigenic variants are a serious public health concern .', 'Their unique immunological properties offer new possibilities for the development of vaccines , which do not cause anaphylactic side effects , a major drawback of specific immunotherapy ( SIT ) .', 'However , there remains a serious problem with regard to the stability and antibody production of the hybrid cell lines .', 'The problem with pure recombinant or synthetic antigens used in modern day vaccines is that they are generally far less immunogenic than older style live or killed whole organism vaccines .', 'Nevertheless , the main problem with the use of native cysticercal antigens is that the native proteins often show cross reactions with sera from humans infected with other parasites .', 'However , a serious problem was detected in one laboratory where the sub-potent vaccine A could have been passed and was not distinguished from the eight-fold more potent vaccine B. There were also indications of possible problems in several other laboratories , where IHR preparation may not be accurately calibrated or where vaccine samples A and B may not be completely distinguished .', 'However , one problem with this approach has been that not all monoclonal antibodies given in vivo eliminate their target cells .', "However , the ' humanization ' of murine monoclonal antibodies ( mAbs ) is a time-consuming and expensive process that has the inherent drawback of potentially altering antigenic specificity and/or affinity .", 'However , the necessity of having thousands of manually annotated examples constitutes a serious concern for the state-of-the-art HEp-2 cells classification methods .', 'A major drawback of subunit vaccines is their inability to generate cytolytic T lymphocytes ( CTL ) , a deficit attributed to segregation of the class I and class II antigen-processing pathways .', 'However , a drawback of Ad vectors is diminished efficacy and toxicity that results from stimulation of innate and adaptive immunity .']


Cluster  437
['The trauma victim with a severe closed head injury , who requires general anesthesia for emergency repair of concomitant exigent major injuries , poses a clinical dilemma .', 'One hundred and sixty-six of the 313 patients who presented with abdominal stab wounds matched our criteria.', "A severe limb injury challenges an anesthesiologist 's ability to provide care .", 'The patient in the case reported here required a quick solution to a severe problem of self-inflicted trauma .', 'Rib fractures are a serious problem in thoracic trauma resulting in high morbidity and mortality .', 'Fifty patients with either a confirmed or suspected diagnosis of facial trauma were independently evaluated by 2 teams of physicians: Face-to-face and telemedicine-based.', 'Major disruption of abdominal wounds continues to be a serious problem , despite the infrequency of its occurrence .', 'Table 6 which lists the cause and time of death of 52 persons with multiple injuries provides evidence that during the first 7 days after a severe accident all surgical intervention that is not absolutely necessary should be avoided and attention focused on the problem of adequate ventilation and primary and secondary complications of shock .', 'Cardiac-related injuries caused by blunt chest trauma remain a severe problem .', 'All participants subsequently completed a high-stress trauma simulation , requiring diagnosis and management of a life-threatening problem .', 'Morbidity and mortality increases when 2 or more wounds are present with multiple organ injuries, in patients with multiple transfusions, or in those transferred to the intensive care unit.', 'There is higher risk of bacterial translocation in patients who required urgent surgical treatment (splenectomy) following blunt abdominal trauma and it is associated with a significant higher number of postoperative infections.', 'Medium to long term clinical outcomes were not solely determined by the severity of injury.', 'Blunt thoracic aortic injury , a life-threatening concern , remains the second most common cause of mortality among all non-penetrating traumatic injuries , second only to intracranial hemorrhage .']


Cluster  1149
["These results shed light on the centrality of therapist responsiveness in treatments for BPD and its impact on very early change in patient's in-session behavioral coping strategies, contributing to the effectiveness of short-term treatments for BPD.", 'Borderline personality disorder ( BPD ) is a severe and generally chronic disorder that presents patients and their family members with multiple challenges .', 'The results indicate that oligodipsia may constitute a serious problem at least for a subgroup of BPD patients , and may be correlated with some of the most problematic symptoms of BPD .', 'Dissociative symptoms including flashbacks , i.e. vivid scenic recollections of traumatic episodes , in patients with Borderline Personality Disorder are a serious and often treatment-refractory problem .', 'Borderline personality disorder ( BPD ) is a severe mental condition characterized by a range of cognitive and behavioral vulnerabilities , including chronic shame and deficits in social problem solving ( SPS ) abilities .', 'Inappropriate treatment of BPD is a serious problem in the US population .']


Cluster  1264
['The study aimed to investigate the effects of synbiotics supplement on improving melasma (evaluated from mMASI score).', 'The impact of GS on skin ageing was assessed ex vivo via different immunohistochemical assays and histology and via a clinical study using biopsies.', 'Oral synbiotics supplementation for 12\xa0weeks improved the severity of melasma score.', 'Melasma is an acquired refractory pigmentary disorder, which is a skin disease that predominantly affects females.', 'GA peel enhances therapeutic efficacy of topical AA cream for treatment of melasma, with improvement in quality of life without serious side effects.']


Cluster  288
['Moser , Moore , and Glendening -LRB- 1996 -RRB- achieved an agreement circularity in expert coding', 'And for each pair of nodes ai and aj there can be an edge aiaj that represents the physical or discourse relation -LRB- i.e. Docent is non-deterministic , i.e. , it can give different results with the same parameter weights', 'And for each pair of nodes ai and aj there can be an edge aiaj that represents the physical or discourse relation -LRB- i.e. Docent is non-deterministic , i.e. , it can give different results with the same parameter weights', 'Moser , Moore , and Glendening -LRB- 1996 -RRB- achieved an agreement circularity in expert coding', 'A drawback of computing each ai locally is that the system does not take into account constraints from mentions outside of the ( mention , antecedent ) pairs']


Cluster  229
['Both RAL 0.', 'MOD-4023 (0.', 'About 0.', 'Non-E.', 'Is 0.', 'A single MAC3.']


Cluster  1784
["In this paper , this semantic interpretation is based only on a weak `` ontological model '' . they adopt a holistic scoring scheme , which summarizes the quality of an essay with a single score and thus provides very limited feedback to the writer", 'This is not necessarily a negative result . they adopt a holistic scoring scheme , which summarizes the quality of an essay with a single score and thus provides very limited feedback to the writer', 'A major weakness of many existing scoring engines such as the Intelligent Essay AssessorTM ( Landauer et al. , 2003 ) is that they adopt a holistic scoring scheme , which summarizes the quality of an essay with a single score and thus provides very limited feedback to the writer', 'This is not necessarily a negative result . they adopt a holistic scoring scheme , which summarizes the quality of an essay with a single score and thus provides very limited feedback to the writer', 'This system was tested on eight essays , but precision and recall figures are not reported . their performances are easily affected by the size of the context window']


Cluster  66
['Despite a growing economy , unemployment remains a severe socio-economic problem in China .', 'The country has a serious foreign debt problem as well as high rate of unemployment and crime , a considerable price inflation , and the pauperisation of the people , particularly among the old .', 'An increase in the rate of relative poverty and the number of welfare recipients is a serious social problem in Japan .', 'Precarious work ( i.e. , work that is insecure and uncertain , often low-paying , and in which the risks of work are shifted from employers and the government to workers ) has emerged as a serious concern for individuals and families and underlies many of the insecurities that have fueled recent populist political movements .', "Precarious work contracts ( lack of formal job stability ) for health workers is a serious problem in Brazil 's primary care system .", 'In addition to contributing to the limited literature on equity in net benefits , the study provides an important policy reference to developing countries with large underground economies and relatively small populations of regular wage-earners as it indicates that using fixed premiums as a major financing scheme may pose a serious equity concern and policy challenge .', 'The measures under the UR were predicted to increase poverty in developing countries , a serious cause for concern since poverty alleviation is a major goal of developing countries .', 'Unemployment ( 5.5 % as of 2015 ) is a serious social and economic problem in our society .', 'Unemployment is a severe problem in Europe since 1980 - 1990 , which is not only economic but also social and medical .', 'Besides the rapid growth of economy , unemployment becomes a severe socio-economic problem in China .']


Cluster  1803
['A total of 23 tube-feeding-dependent adult patients were included in this multicentre, open-label study.', 'Owing to the frequency of gastrostomy tube placement in children and the numerous regimens used to start feeds after placement we attempted to see if it matters if the initial feeds after a gastrostomy tube placement are provided in a bolus or continuous manner.', "To investigate the effects of a tube feeding formula (TFF) on patients' nutritional status, biochemical status, bowel habits and safety.", 'Other than minor, clinically insignificant differences noted above, the method of initial feeding after a gastrostomy tube placement does not affect feeding tolerance or gastrostomy tube complication in the first month after placement.', 'Using a prospective randomized trial, children were randomized to initial bolus or continuous chimney feeding after gastrostomy tube placement.']


Cluster  415
['We prospectively recruited patients in 2 phases.', 'Prospective randomized controlled trial.', 'This is a hospital based prospective observational study.', 'Prospective observational study.', 'Prospective randomized comparative (controlled) study.', 'Prospective observational study.', 'We conducted a prospective cross-sectional observational pilot study.', 'Prospective observational study.', 'Community-based prospective observational study.', 'A prospective observational study was carried out.', 'A prospective observational study design based upon a convenience sample of patients was conducted over a randomly selected four-week period.', 'Prospective clinical study.', 'This was a prospective interventional study.', 'Prospective observational clinical trial.', 'This was a prospective observational study done in a tertiary care center.', 'We conducted a prospective observational study.', 'We performed a nationwide cohort study.', 'Prospective, randomized controlled trial.', 'This was a prospective observational study performed in two phases.', 'We carried out a prospective observational study.', 'A prospective, observational cohort study was completed.', 'Prospective clinical study.']


Cluster  425
['Flow chemistry : a light touch to a deadly problem .', 'Rapid destabilization of FSH receptor after solubilization by detergents is a serious problem complicating its purification and further study .', 'A drawback of this innovative technology is that problems are encountered when processing high-concentrated amorphous materials , particularly protein formulations .', 'This is a serious problem for weakly retained analytes under 100 % aqueous mobile phase conditions .', 'The low solubility of drugs , which poses a serious problem in drug development , can in part be overcome by the use of cyclodextrins ( CDs ) and their derivatives .', 'However , disassembly of the VLPs on the solid-liquid interface during chromatography process could be a serious problem .', 'Adsorption to surrounding materials may be a serious problem of protein measurements in solutions with low protein concentrations .', 'The limits that cyclodextrin products impose on their industrial production from starch by cyclodextrin glycosyltransferases ( CGTases ) are a severe problem .', 'A severe multicollinearity problem has been removed by the addition of several specific rates of solvolysis in fluoroalcohol-containing solvents .', 'A major drawback of C(60 ) for bioapplications is its insolubility in water .', 'Liquid-liquid phase separation ( LLPS ) of protein solutions into protein-rich and protein-poor phases reduces solution stability at intermediate concentrations and lower temperatures , and is a serious concern in formulation development as therapeutic proteins are generally stored at refrigerated conditions .', 'Although strain-promoted alkyne-azide cycloadditions ( SPAAC ) have found wide utility in biological and material sciences , the low polarity and limited water solubility of commonly used cyclooctynes represent a serious shortcoming .', 'Therefore , mixing becomes both a serious problem and necessity to overcome that diffusion limitation and homogenize the samples , especially for the biochemical reactions that take place in multiwell plates .', 'Moreover , this strategy makes also easy the desorption step that requires rather low NaCl concentrations , which may become a serious problem for desorption of large proteins when using conventional supports , due to their ability of generating a very strong adsorption .', 'This high desorption efficiency was achieved even without typical aiding agents by means of a formamidine disulfide-mediated route that prevented thiourea consumption , which is considered a major drawback of the otherwise promising reagent .']


Cluster  254
['Isokinetic muscle strength training is presently the most advanced method of muscle strength training', 'Clinical practice guidelines recommend a\xa0multimodal intervention based on standardized screening for the treatment of frailty, which includes physical exercise as the main component.', 'Preliminary results show that exercise according to protocol is tolerable and feasible.', 'The program decreased postural pain, spinal curvatures, and postural sway, and increased core endurance in university students.', 'Compared to the non-exercise group, VO<sub>2peak</sub> improved with CR exercise training (Difference: +4.', 'To assess the effectiveness of a program of postural exercises and assess the effectiveness in term of pattern of muscular hyperactivity.', 'Isogai dynamic therapy (IDT) is one of Japanese stretching interventions and has been practiced for over 70 years.', 'A total of 27 children with bilateral CP, 5 to 17 years old, were randomized to 12 weeks of 20 minutes, 5 days per week home-based training (elliptical = 14; cycle = 13) at a minimum of 40 revolutions per minute, with resistance added when speed target was achieved.', 'In MI patients who completed CR exercise training, LV twist and twist velocity decreased, whereas these parameters increased in patients who did not exercise.', 'To quantify and compare effectiveness of a motor-assisted cycle and a novel alternative, an elliptical, in CP to improve interlimb reciprocal coordination through intensive speed-focused leg training.', 'The current results indicate that exercise during pediatric HSCT is feasible and contributes to prevention of treatment-related loss of physical function.', '6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men.', 'Weight bearing exercise may play an important role in increasing or maintaining BMD in children with CP and is also expected to promote bone growth.']


Cluster  2102
['Chronic kidney disease ( CKD ) represents a serious concern for the Mexican population since the main predisposing diseases ( diabetes , hypertension , etc . ) have a high prevalence in the country .', 'Chronic kidney disease is a serious health problem in El Salvador .', 'Over the last 20 years , many reports have described an excess of cases of chronic kidney disease ( CKD ) in the Pacific coastal area of Central America , mainly affecting male farmworkers and signaling a serious public health problem .', 'End-stage renal disease represents a serious public health problem in Mexico .', 'End-stage renal disease represents a serious public health problem in Jalisco , Mexico .']


Cluster  836
['It was concluded that group spiritual intervention as a useful method could be effective in enhancing self-esteem and happiness among addicted individuals undergoing methadone maintenance treatment.', 'For example , a serious problem of alprazolam abuse may exist among patients in methadone maintenance treatment .', 'Addiction to analgesics and tranquilizers remained a serious problem in these patients even after they were placed on chronic hemodialysis .', 'Substance use disorder is characterized by repeated use of a substance , leading to clinically significant distress , making it a serious public health concern .', 'Strategies should be developed to assess and address individual needs and treatment approaches should be tailored to address depressive symptoms in young, sexual minority club drug users.', 'The co-occurrence of mental and physical disorders related to substance abuse of treated patients is more often a serious problem to medical services .', 'Hence , we discuss : ( 1 ) why persons with substance use disorders are at increased risk for infection with COVID-19 and a severe illness course ; ( 2 ) anticipated adverse consequences of COVID-19 in persons with substance use disorders ; ( 3 ) challenges to health care delivery and substance use treatment programs during and after the COVID-19 pandemic ; and ( 4 ) the potential impact on clinical research in substance use disorders .', 'All patients in the present study received compulsory drug detoxification in Shanghai Drug Rehabilitation Center.', 'Substance use disorders ( SUD ) and behavioral addictions are devastating conditions that impose a severe burden on all societies , and represent difficult challenges for clinicians .', 'This study was an intervention study in which 60 clients affected with substance abuse and undergoing methadone maintenance treatment were recruited.', 'High relapse rate of drug-dependent patients is a serious problem in the current situation .', 'Patients recovering from substance use disorders are commonly seen in the primary care setting , and relapse is a serious long-term problem for these patients .', 'Among opioid-dependent patients on maintenance therapy , concomitant drug abuse is a serious problem .', 'Addiction to alcohol and other drugs is a serious public health problem that is one of the most common disorders seen in medical practice .', 'Though substance abuse and its deleterious health sequelae are a serious problem in Taiwan , licit and illicit substance use patterns among nurses are understudied .', 'Drug dependence , the physical and psychological one after chronic drug administration , is a serious clinical and social problem .', 'Concomitant opioid abuse is a serious problem among patients receiving methadone maintenance treatment ( MMT ) for opioid use disorder .', 'Addiction to alcohol and other drugs is a serious public health problem that is one of the most common disorders seen in medical practice .']


Cluster  1549
['Ischemic heart disease is a serious health problem because it causes considerable mortality and morbidity .', 'Despite rapid progress in cardiology and cardiac surgery , cardiovascular disease still present a serious epidemiological problem in industrialized countries , including Poland .', 'Cardiovascular disease is recognized as a serious public health problem .', 'The growing momentum of several common life-style diseases such as myocardial infarction , cardiovascular disorders , stroke , hypertension , diabetes , and atherosclerosis has become a serious global concern .', 'As you know , atherosclerosis is a serious public problem and is the leading cause of morbidity and mortality not only in Western countries but also in Asia .', 'Cardiovascular disease is the leading cause of global mortality , yet its early detection remains a vexing problem of modern medicine .', 'Despite major advances in the diagnosis and treatment of atherosclerotic cardiovascular disease ( CVD ) in the past century , it remains a serious clinical and public health problem .', 'Coronary artery disease ( CAD ) , along with its main complications such as acute myocardial infarction ( AMI ) and congestive heart failure ( CHF ) , remains a serious worldwide problem and affects many patients despite the improvement of medical treatment .', 'Cardiovascular disease remains a serious medical problem , which can be associated with death and disability on one hand , and considerable resource utilization on the other .', 'Despite impressive gains in diagnosis and treatment , cardiovascular disease ( CVD ) remains a serious clinical problem and threat to public health .', 'Cardiovascular disease is a serious problem in the United States .', 'Diseases of the cardiovascular system , such as hypertension , myocardial infarction , ischaemia , etc . represent a serious medical problem and a frequent cause of the human death .', 'The biggest threat to life are cardiovascular diseases which are a serious problem in Poland , Europe , and worldwide .', 'Ischemic heart diseases are a serious health problem worldwide .', 'Cardiovascular diseases ( CVD ) remain a serious public health problem and are the primary cause of death worldwide .', 'Atherosclerotic disease is a leading cause of morbidity and mortality in adults and is generally thought of as only affecting adults', 'Coronary artery disease ( CAD ) remains an important cause of morbidity and mortality and is a serious public health problem .', 'Atherosclerosis represents a serious global health problem that demands new therapeutic and prophylactic interventions .', 'Cardiovascular disease is a serious public health problem ; it is the first " cause of death " in Brazil and in developed countries .', 'Atherosclerosis is a serious public health concern .']


Cluster  1999
['Exome and genome sequencing is becoming the method of choice for rare disease diagnostics', 'Baseline cfDNA levels were higher in recipients (37.', 'A total of 145 DNA samples were collected from children with malignant disease.', 'Whole exome sequencing was performed on 2 cousins with ARVC.', 'We experienced that increasing the resolution of a whole genome screen in the diagnostic setting has its drawback of detecting an increased number of CNVs with uncertain contribution to a phenotype .', 'To investigate gene mutations in tumor DNA and cfDNA collected from 43 melanoma patients and evaluate their potential as biomarkers.', 'Gene variants, including BRAF, NRAS, TP53, GNAS, and MET, were detectable in the plasma cfDNA, and the results were partially consistent with the results of those identified in the tissues.']


Cluster  64
['RDW values significantly predicts long-term all-cause mortality in critically ill patients with severe sepsis beyond conventional severity scores.', 'Pneumonia is a major cause of mortality worldwide and a serious problem in critical care medicine , but the immunophysiological processes that confer either protection or morbidity are not completely understood .', 'Ventilator-associated pneumonia ( VAP ) is a serious concern for patients in the Neuroscience Intensive Care Unit ( NSICU ) .', 'The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP).', 'Ventilator-associated pneumonia ( VAP ) is a serious and costly clinical problem .', 'VAP is a serious problem in ICU carrying many risks for the patient live .', 'Ventilator associated pneumonia (VAP) is a leading cause of death.', 'Enterocyte injury was common in critically ill patients with pneumonia.', 'In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated.', 'To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients.']


Cluster  756
['Alcohol-based disinfectant shortage is a serious concern in the severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) pandemic .', 'Coronavirus-19 causing a severe acute respiratory disorder in humans and becoming a major health problem .', 'Severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) infection is now a serious public health problem .', 'The novel coronavirus disease 2019 ( COVID-19 ) caused by severe acute respiratory syndrome coronavirus-2 infection is a serious global concern .', 'The morbidity of SARS-CoV-2 ( COVID-19 ) is reaching 3 Million landmark causing and a serious public health concern globally and it is enigmatic how several antiviral and antibody treatments were not effective in the different period across the globe .', 'During the 2003 severe acute respiratory syndrome ( SARS ) outbreak in Toronto , the potential introduction of SARS into the homeless population was a serious concern .', 'Since SARS showed a severe case fatality ratio , our concern is to know such a case fatality ratio as soon as possible after a similar outbreak begins .', 'With limited vaccine supplies, an informed position on the status of SARS-CoV-2 infection in people can assist the prioritization of vaccine deployment', 'The COVID-19 pandemic , caused by severe acute respiratory syndrome corona virus 2 ( SARS-CoV-2 ) , has become a severe global health problem affecting almost every country in the world .', 'Infection caused by the new coronavirus ( SARS-CoV-2 ) has become a serious worldwide public health problem , and one of the most important strategies for its control is mass testing .', 'Delay in vaccine production is a serious problem in responding to a pandemic situation , such as that of the current H1N1 strain .', 'BACKGROUND Coronavirus disease ( COVID 19 ) is caused by severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) and is the causative agent of a serious disease that is of great global public health concern .', 'As COVID-19 is posing a serious threat to global health , the emerging mutation in SARS-CoV-2 genomes , for example , N501Y substitution , is one of the major challenges against control of the pandemic .', 'Considering the expected availability of a severe acute respiratory syndrome coronavirus 2 vaccine for distribution and dispensing to the public , our findings highlight critical considerations for planning possible future mass vaccination events , including during the novel coronavirus disease 2019 pandemic .', 'A drawback of the current mRNA-lipid nanoparticle ( LNP ) COVID-19 vaccines is that they have to be stored at (ultra)low temperatures .', 'Middle East respiratory syndrome coronavirus ( MERS-CoV ) infections continue to be a serious emerging disease problem internationally with well over 1000 cases and a major outbreak outside of the Middle East region .', 'Middle East respiratory syndrome coronavirus ( MERS-CoV ) recently emerged as a severe worldwide public health concern .', 'SARS-CoV-2 is affecting different countries all over the world, with significant variation in infection-rate and death-ratio', 'Vaccines for SARS , MERS and RSV have never been approved , and the data generated in the development and testing of these vaccines suggest a serious mechanistic concern : that vaccines designed empirically using the traditional approach ( consisting of the unmodified or minimally modified coronavirus viral spike to elicit neutralising antibodies ) , be they composed of protein , viral vector , DNA or RNA and irrespective of delivery method , may worsen COVID-19 disease via antibody-dependent enhancement ( ADE ) .', 'Severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ) is the causative agent of the ongoing coronavirus disease 2019 ( COVID-19 ) pandemic that is a serious global health problem .']


Cluster  410
['The aim of the article was to investigate possible associations between plasma concentrations of cTnI and NT-proBNP, respectively, and patient characteristics, glomerular filtration rate (GFR), a plasma volume factor (PVF) derived from scintigraphic examination (PVf), systolic blood pressure (SBP), selected hematologic and biochemical variables, and echocardiographic measurements in dogs with stable chronic kidney disease (CKD) and in healthy dogs.', 'To determine the effect of dietary counseling on sodium intake and consequent BP control in kidney allograft recipients.', 'Significant histopathological alterations in the kidney were observed in patients with WCH and SH, and were accentuated in WCH patients with non-dipper blood pressure pattern.', "WBV program would induce physiological responses that must be taken into consideration in adults' kidney transplant recipients.", 'PVAN was the leading cause of renal loss in SPK patients in the first 2 years after transplantation and is a serious concern for SPK recipients .', 'Dietary counseling showed a short-term efficacy of reducing sodium intake and clinically relevant BP improvement in renal allograft recipients.', 'Our results demonstrate beneficial effects of the periodic swimming on ameliorating hypertension-induced kidney dysfunction highlighting the potential of swimming exercise as a nonpathological therapy for early prevention of hypertension-caused kidney diseases.', 'Starting in May 2018, we are conducting an observational study with a 1-year follow-up on PAL in patients from 4 hemodialysis clinics in New York City.', 'Automated office blood pressure measurements should be considered the method of choice in kidney transplant recipients.', 'To investigate the impact of kidney function (using estimated glomerular filtration rate, [eGFR]) on blood pressure variability (BPV) via a retrospective post hoc analysis of patients with hypertension enrolled in two large clinical trials.', 'We conducted a prospective observational study including 11 kidney transplant recipients.', 'This retrospective observational cohort study included adult chronic kidney disease patients.']


Cluster  1272
['In this observational study, a single-channel aEEG recording (Olympic CFM 6000) with corresponding EEG signal was obtained from 32 infants at a gestational age of 36-44 weeks.', 'Children resuscitated from cardiac arrest underwent continuous conventional EEG monitoring.', 'These data support the use of the standardized terminology and the composite overall background category as a basis for standardized EEG interpretation for subsequent studies assessing EEG background for neuroprognostication after pediatric cardiac arrest.', 'We performed EEG monitoring in 89 consecutive children, which yielded 453 EEG segments.']


Cluster  2249
['It was not a serious problem in children aged 7 years and older ; scans in 6-year-old children were diagnostic but not ideal .', "In general , Adie 's syndrome does not represent a serious diagnostic problem .", 'In spite of this it is not considered a serious problem by the health authorities .', 'Its adverse effect is relatively not a serious problem .', 'Impaired performance of motor skills , to the degree experienced by clumsy children , is unlikely to present a serious problem .', 'It is often resolved with supportive therapies and consequently not considered a worrisome problem .']


Cluster  302
['Ground subsidence is not a severe problem at Wairakei but may prove to be one at the nearby Broadlands field .', 'Organic pollution is no more a severe problem in the Stever .', 'The present data suggest that the effects of calf breed do not place a serious problem on the economic traits of Holstein dams .', 'At present , intensive fish culture does not pose a serious animal welfare problem in Germany .', 'Contamination was not a severe problem if all operations were performed in a dust-free atmosphere .', '  With the Viking mission , the sampling rate was not a serious problem because samples were acquired over a period of one year .', 'According to Swedish guidelines for environmental quality of contaminated sites , heavy metal concentration in the sweeping waste can not be considered as a serious problem .', 'Contamination rate was reduced from 40% to 25% by the intervention.']


Cluster  1247
['Five patients with APMPPE were included.', 'The total incidence of IH was 4.', 'The rates of major adverse cardiac events were 5.', 'Four patients died; all were in the ALF group.', 'Depression assessed by the PHQ-9 was found in 5.', 'The totality of cases was 3264, with an incidence of 5.']


Cluster  900
['Prostate cancer is a serious health problem in the Caribbean with high incidence and mortality rates affecting a predominantly Black population .', 'Prostate cancer is the most prevalent cancer in males and its incidence is steadily increasing.', 'Prostate carcinoma ( PCa ) is the most common male cancer in industrialized societies and represents a serious public health problem .', 'Aging of population in Macau has become a serious problem and we are diagnosing more and more patients with prostate cancer .', 'The high incidence and subsequent mortality from prostate cancer in progressively older US males is a serious health concern .', 'Prostate cancer ( PC ) is a serious health problem all over the world .', 'Prostate cancer represents a serious health problem worldwide .', 'Decreased participation in prostate cancer screening by African American men is a serious problem , as decreased survival rates occur when the diagnosis of prostate cancer is delayed .', 'Prostate cancer (PCa) is a complex disease that disproportionately impacts Black men in the USA', 'Prostate cancer is a serious health care problem in the United States .', 'Prostate cancer ( PC ) is a serious public health problem in the United States , especially in African-American men ( AAs ) .']


Cluster  1551
['MTL was successfully applied in some Natural Language Processing -LRB- NLP -RRB- tasks . lexical sparsity', 'In this paper we leverage the existing linear model -LRB- Equation 2 -RRB- to bring source-side context into phrase-based MT in a way that is robust to data sparseness . it gives poor results when the number of clusters is different from the real number of valid classes', 'In this paper we leverage the existing linear model -LRB- Equation 2 -RRB- to bring source-side context into phrase-based MT in a way that is robust to data sparseness . it gives poor results when the number of clusters is different from the real number of valid classes', 'MTL was successfully applied in some Natural Language Processing -LRB- NLP -RRB- tasks . lexical sparsity']


Cluster  590
['Dysmenorrhea is a serious public health problem which can be incapacitating .', 'Approximately 12 % of those who reported dyspareunia and/or vaginal dryness claimed a severe problem ; 33 % did not seek professional advice and 36 % resorted to an over the counter remedy .', 'Only 38 % ( 95 % confidence interval 34 % to 41 % ) of women reported excessive menstrual loss as a severe problem .', 'Finding an effective and safe method for the treatment of PMS has always been a serious concern , because approximately 40 % of women report PMS , and in 2 - 10 % of cases it is severe enough to affect their life style and job .', 'Mean score of overall symptoms of PMS between the Bitter orange and control groups In the first (p\u202f<\u202f0.', 'A randomized prospective controlled study was conducted concerning the effects of progressive relaxation exercises on the reduction of pain in primary dysmenorrhea.', 'The aromatherapy with Citrus aurantium blossom improved the symptoms of premenstrual syndrome.']


Cluster  586
['A prospective, open label, single-center, randomized controlled trial was performed.', 'The study is a randomized controlled study ongoing over 112\u2009days.', 'We conducted a randomized, four-period, cross-over, single-dose study.', 'In this open-label, single-center trial, 25 participants took 2.', 'We will conduct a single-center, randomized, parallel group, and assessor-blinded clinical trial.', 'This was a phase I, open-label, non-randomized, multicenter trial.', 'Single-blinded, randomized controlled trial held from December 2014 until September 2015.', 'HOMEX-1 and HOMEX-2 are multicentre, parallel group, randomised controlled trials.', 'A secondary analysis was undertaken from our parent National Institutes of Health-funded randomized controlled trial (NIH R01 NR016702).', 'This study is a quantitative experimental pilot clinical trial.', 'Three arm assessor-blinded Randomized Clinical Trial (RCT).', 'This is a prospective, double-blind, signal-center clinical trial.', 'Prospective, double arm, phase 2, randomized study.', 'This trial was prospective, randomized, controlled, double blinded, and centrally administered.', 'A prospective, multicenter, double-blind, controlled trial.', 'Randomized controlled trial (RCT) with three conditions.', 'We performed an international, multicentre, open-label, prospective trial.', 'This is a randomized controlled clinical trial.', 'This clinical trial has been designed as a prospective, single-centre, explorative, controlled, observational study.', 'The study is a prospective, randomized, controlled, single-blinded trial with parallel arms.', 'This is a phase II, single-centre, randomised, double-blind, active-controlled, parallel-group pragmatic trial.', 'In this prospective, monocentric, two-armed, non-blinded randomized, controlled clinical trial, a total of 43 participants were included.', 'This was a prospective, single-center, open-label controlled study.', 'A single group, pretest-posttest clinical trial was used.', 'The study is designed as a two-arm cluster, randomized, controlled trial with a 4-month follow-up.', 'This clinical trial was conducted in 2018-2019.', 'The trial (clinicaltrials.gov NCT02385929) is a multicenter randomized controlled trial (RCT) with a parallel-group randomization (1:1).', 'A randomized, comparative clinical trial, using two groups, was conducted over 6 months.', 'Subjects completing the initial six-month study were enrolled in this 24-month, randomized, multicenter, double-blind, split-face, extension study.', 'This clinical trial was performed in 2019 to 2020 in Khorshid Hospital, Isfahan, Iran.', 'It is a single-arm phase II clinical trial conducted at a Brazilian referral centre.', 'This is a two-arm, parallel group, multicenter, randomized, sham-controlled trial with concealed allocation, and participants, assessor, and analyst blinding.', 'This was an open-label trial conducted at Karabuk University Training and Research Hospital between May 2016 and January 2018.', 'Two-arm, Internet-based, randomized, wait-list controlled trial (RCT).', 'This study was a single-center open-label randomized controlled trial.', 'A two-arm, randomized controlled trial was carried out between November 2018 and December 2019.', 'A randomized controlled trial was conducted from November 2018 to April 2019.', 'A multi-center, prospective, non-controlled clinical trial was reviewed.', 'To describe the statistical analysis plan for this randomised clinical trial comprehensively and place it in the public domain before unblinding.', 'Single-centre, open-label, randomized controlled trial.', 'This is a multinational, multicenter prospective randomized trial.', 'This is a two-armed 1 : 1 randomized non-blind experimental study.', 'A double-blinded, randomized, controlled trial was conducted in January 2019.', 'Prospective, randomized, double-blinded, placebo-controlled clinical trial.', 'A randomized, open-label, single dose, two-sequence, two-period crossover clinical study was conducted.', 'This was a randomized, double-blind, four-way crossover, placebo- and active-controlled phase II study (trial registration number JapicCTI-132213).', 'This is a randomized, open, active-controlled, prospective, Phase IV trial.', 'This was a comparative study within a randomized controlled trial (NTR4948).', 'This was a randomized sham-controlled clinical trial from 2008 to 2015.']


Cluster  1614
['The gait plate insole with ordinary shoes and shoes only were able to increase angle of gait and the center of pressure displacement in the anterior-posterior direction in children with in-toeing gait due to excessive femoral anteversion.', 'Walking gait analysis was performed on 20 individuals with knee osteoarthritis, in their own shoes, with and without a six millimeter lateral wedge insole.', 'The gait plate insole with shoes as well as shoes alone produced a significant 11.', 'Lower-extremity gait kinetics were characterized by a significant decrease, greater than 6%, in second peak knee adduction moment in laterally wedged insole conditions compared to the other conditions ( p\u2009<\u20090.', 'The aim of this study was to investigate the immediate effect of gait plate insole on the angle of gait and center of pressure displacement in children with in-toeing gait.', 'Neither prefabricated insoles nor custom-made orthoses (weight-bearing or nonweight-bearing) modified GRF.', 'No significant differences were observed in the phases of the gait cycle between the prefabricated, the weight-bearing, and the nonweight-bearing foot orthoses.', 'Shoes, with their biomechanical features, affect the human body and function as clothing that protects the foot']


Cluster  283
['Subjects were randomized in a 4:3 ratio to nebulized glycopyrrolate 50\xa0μg twice daily (BID) or tiotropium 18\xa0μg once daily (OD) and treated for 48 weeks.', 'On-demand therapy using 20-mg vonoprazan tablets is an effective alternative maintenance therapy for mild RE.', 'In this single-dose, open-label, crossover study, healthy adults (age range, 18-65 years) were randomized equally to one of six treatment sequences for three 72-hour treatment periods with GSP301 (olopatadine 665 μg-mometasone 50 μg), the mometasone furoate monotherapy component of GSP301 (MF-sponsor, 50 μg), and U.S. Food and Drug Administration-approved mometasone (MF, 50 μg); all the treatments were administered as two sprays per nostril.', 'The results of 2 randomized, double-blind, vehicle-controlled, single-dose, parallel, clinical studies (Study 1, n=67; Study 2, n=61) in which the efficacy of an oxymetazoline (0.', 'In this prospective, randomized, double-blinded study, 78 patients were randomly assigned to the control group (n\u200a=\u200a39; no glycopyrrolate administration) or the glycopyrrolate group (n\u200a=\u200a39; 0.', 'This study shows for the first time, that oxymetazoline provides both statistically significant and clinically meaningful relief of nasal congestion and improves nasal airflow for up to 12 hours following a single dose.', 'Long-term tafamidis was associated with a favourable safety/tolerability profile, without any unexpected adverse events.', 'In these 2 studies in healthy subjects, tedizolid administered for up to 21 days was not associated with drug-related ophthalmologic or neurologic adverse events.', 'This study revealed that pilocarpine had no significant effect on the radioiodine content of parotid glands during the first 48\u2009h after radioiodine administration.', 'Treatment with nebulized glycopyrrolate was well tolerated over 48 weeks with the most common adverse events being COPD worsening and cough.', 'RT001 was found to be safe and tolerable over 28 days, and improved peak workload.', 'Trofinetide was well tolerated in adolescent and adult females with Rett syndrome.']


Cluster  692
['Despite the advances in reconstructive vascular surgery anastomotic pseudoaneurysms have remained a serious problem .', 'Aneurysm or ectasia was observed in 49 of 1578 patients (3.', 'Our prospectively collected database (2010-2013) included 123 consecutive patients who underwent clipping of 133 cerebral aneurysms with use of IONM.', 'This prospective, observational study was conducted in 100 consecutive patients with a-SAH undergoing clipping of ruptured aneurysm.', 'The study is designed to determine the efficacy of lamina terminalis fenestration on the reduction of SDH after aneurysm clipping.', 'As the first UK study to characterise the angiographic prevalence of Kawasaki Disease, both aneurysm and ectasia were observed with a relatively low frequency.', "Aortic aneurysm is a serious problem in Behçet 's disease , but open surgical therapy carries the risk of recurrent pseudoaneurysm .", 'Recanalization of previously coiled aneurysms remains a major drawback of endovascular aneurysm therapy .', 'Thirty-nine atherosclerotic aneurysm patients were operated between January 2007 and July 2015 at Rouen University Hospital.', 'Pseudoaneurysms are not a common complication of the endovascular procedures but can present a serious therapeutic problem .']


Cluster  1754
['Recurrence of Hepatitis B Virus infection in patients undergoing liver transplanted ( LT ) is a serious and often fatal problem .', 'Reactivation of hepatitis B virus ( HBV ) after cytotoxic chemotherapy is a serious problem , and it occurred to 41 % of breast cancer patients carrying HBV .', 'Hepatitis B virus ( HBV ) reactivation in immunosuppressed cancer patients is a serious clinical problem for HBV carriers undergoing chemotherapy , because it may result in severe liver injury and prevent completion of life-saving treatment of the underlying malignant disease .', 'HBV reactivation and severe liver disease during cytotoxic treatment may become a serious and common problem in this region as cytotoxic chemotherapy is more widely used .', 'Hepatitis B virus ( HBV ) reactivation from resolved infection is a serious problem which can frequently lead to severe hepatitis .']


Cluster  1135
['We evaluated the effectiveness of 10 vs.', 'This was a prospective randomized intrapatient, right-left, assessor-blinded comparison of Nd:YAG vs IPL.', 'The grading criterion on our 12-point scale revealed an improved discrimination compared to the wide range grading system.', 'Statistical analysis of 52 patients who completed the study showed high agreement between the paper and software version of the questionnaire (intraclass correlation coefficient 0.', 'Our aim was to evaluate the efficacy and safety of 2.', 'Prospective nonrandomized comparative study.', 'The goal of this study was to determine the sensitivity and specificity of some widely used, easily administered clinical tests.', 'The clinical efficacy was evaluated according to the NAPSI score.', 'To compare scores obtained from computerized adaptive test to scores obtained from fixed-length short forms (7-item and 12-item) in order to provide guidance to researchers and clinicians on how to select the best form of administration for different uses.', 'This study is the largest comparing the two measurements, and shows good clinical agreement.', 'The bias and 95% limits of agreement of the new method are narrow and not clinically relevant, supporting the potential interchangeability of the two methods of EOAproj calculation.']


Cluster  762
['The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem .', 'A major drawback of the FCMMN assay is that a false-positive interpretation could result from the presence of large numbers of apoptotic or necrotic bodies in the measured sample .', 'A problem with tangential excision has been that the amount of tissue excised is often greater than the amount of necrotic tissue .', 'A drawback of the technique is that it is difficult to distinguish between small gaseous emboli and large solid emboli .', 'A drawback of both methods was the large number of not evaluable arteries ( 6 in MRA , 11 in color Doppler sonography ) .', 'One problem with this approach is that the examiner may not direct the beam transversely and , therefore , may not accurately identify the outflow tract anatomy .', 'Ultrasound images showed statistically significant (p < .', 'A main drawback of this method is the need to use a nephrotoxic iodinated contrast medium to visualize the aorta and its side branches .', 'However , a generally acknowledged drawback of this technique is the limited sample volumes which can be loaded onto the CE capillary which results in a poor concentration limit of detection .', 'The problem with FC studies in patients is that it is not straightforward to focus on a specific aspect of pathology .', 'The results confirm the suspicion that considerable output variations exist and suggest a serious problem to the practitioner wishing to expand his radiographic technique armementarium .', 'A problem with the use of ultrasonography is that the mild lesions likely to be observed in population surveys are not always easy to assess .', 'A drawback of the necropsy-based assessment is that it is based on visual observations and condition factors , which are not as sensitive as tissue and subcellular biomarkers for sublethal effects .']


Cluster  598
['Our results indicate that anodal cerebellar tDCS with a reference electrode positioned over the buccinator area modulates pain processing in the ipsilateral leg.', 'Vestibular stimulation integrated with NDT proved to be an effective complementary strategy for facilitating motor functioning.', 'Dry-electrode-based transcranial direct current stimulation is a new type of non-invasive brain stimulation system which relieves chronic low back pain and improves related muscle movement , in a way that overcomes the drawback of conventional systems .', 'Dual-afferent sensory input, which combines electromyography-triggered functional electric stimulation (ETFES) and action observation, was investigated to determine its effects on voluntary movements in stroke patients.', 'No significant impact of tDCS was seen on any parameter of smRT distribution, error rate, or miss rate, regardless of polarity, stimulation intensity, electrode montage, or stimulation-to-task relationship.', 'Thirty-four subjects were submitted to single-pulse transcranial magnetic stimulation (TMS) over the right primary motor cortex to measure Input-Output (IO) curve as a measure of corticospinal excitability.', 'A significant decrease of MEPs amplitude and of IO curve slope steepness was found after the combination of rightward PA and anodal tDCS; on the other hand, an increase of MEPs amplitude and of the steepness of IO curve slope on the right motor cortex was found following either rightward PA or anodal tDCS.', 'The aim of the present study was to test whether neuromodulatory effects obtained from tDCS and prismatic goggles could interact and induce homeostatic changes in corticospinal excitability.', 'This study aims to assess the efficacy of functional electrical stimulation therapy in improving voluntary reaching and grasping after severe hemiplegia.', 'High-definition transcranial direct current stimulation ( HD-tDCS ) seems to overcome a drawback of traditional bipolar tDCS : the wide-spread diffusion of the electric field .', 'A drawback of bi-polar nerve recordings obtained during tethered flight was overlay of nerve activity with large amplitude muscle potentials .', 'The aim of this study was to assess the efficacy of a vestibular stimulation training in improving motor functions in cerebral palsy.']


Cluster  825
['A drawback of the method is that most organic photosensitizers are disposable and consumed during the photochemical reactions and as a consequence a much larger amount of photosensitizer than that of the metal source is usually required , and therefore , the photosensitized reduction method is wasteful in terms of the sensitizer .', 'A major drawback of the current technique is that the luminescent lanthanide labels require ultraviolet ( UV ) excitation , typically shorter than 360 nm , which is strongly absorbed and can damage living biological systems .', 'One very attractive advantage of this system is that using NIR light irradiation does not cause significant photodamage , a serious problem in molecular based artificial photosynthesis under visible light irradiation .', 'A major drawback of the current technique is that the luminescent lanthanide labels require UV excitation ( typically less than 360 nm ) , which can damage living biological systems and is holding back further development of time-resolved luminescence instruments .', 'Antibiotic pollution has been a serious global public health concern in recent years , photodynamic inactivation is one of the most promising and innovative methods for antibacterial applications that avoids antibiotic abuse and minimizes risks of antibiotic resistance .', 'In this study, we aim to compare the photodynamic inactivation (PDI) effects of two different photosensitizers (PS), Photogem<sup>®</sup> and Natural Curcumin, irradiated with light-emitted diodes (LED) at 630 and 450\u2009nm, respectively.', 'However , a serious drawback of most chromophoric molecules is photobleaching over the course of their use in biological environments , which severely compromises the desired theranostic effects .']


Cluster  1017
['The appearance of multiple drug resistance along with resistance to quinolones in this bacterium poses a serious therapeutic problem .', 'High fluoroquinolone resistance in ETEC may be a serious cause of concern for travelers visiting this region , and thus thereis a need to monitor drug resistance in this pathogen .', 'Fluoroquinolone is widely used for the treatment of bacterial diseases , and the emergence of quinolone resistance has become a serious concern in recent years ,', 'It was concluded that quinolone-resistance in E. coli remains a serious problem in Hebei , China .', 'Fluoroquinolone ( FQ ) resistance of Bacillus anthracis is a serious concern in the fields of biodefense and bioterrorism since FQs are very effective antibiotics and are recommended as first-line treatment against this lethal bacterium .', 'Widespread horizontal transfer of these genes among bacteria may be a serious public health concern because these can rapidly increase fluoroquinolone resistance .', 'As with all classes of antibiotics , resistance to fluoroquinolones is a serious concern , and multiple avenues for resistance are being investigated .', 'The resistance of R. anatipestifer to quinolone agents is a serious problem .', 'In contrast the occurrence of strains of C. albicans resistant to 5-fluorocytosine is a serious clinical problem .', 'To date resistance among individual yeast species or strains has only been a serious problem with flucytosine .', 'Fluoroquinolone resistant S. Typhi constitute a serious public health concern in endemic areas as well as in industrialized countries .']


Cluster  292
['The investigated reaction and its surprising blue product represent a case study of the application of modern materials science to conservation and a serious warning towards the unpredictable challenges faced in the preservation of our cultural heritage .', 'As it has been confirmed by numerous conservators and researchers , the presence of metal compounds is a serious problem not only due to their destructive influence on wood tissue but also from a conservation/re-conservation perspective .', 'The formation of metal soaps ( metal complexes of saturated fatty acids ) is a serious problem affecting the appearance and structural integrity of many oil paintings .', 'Corrosion of metals is a serious and challenging problem faced worldwide by industry .', 'The disposal of chromated copper arsenate (CCA)-treated waste wood is becoming a serious problem in many countries due to potential leaching of hazardous elements from in-service use in the environment or disposal of solutions after remediation ; therefore , it is necessary to develop proper remediation techniques .', 'Internal corrosion of piping is a serious problem in drinking water industry .', 'The corrosion of refractories by sodium salts in waste liquid at high temperature has become a serious problem .']


Cluster  1296
['Ninety patients who were candidates for rhinoplasty were randomly divided into three groups.', 'Patients who have evidence of structural nasal obstruction were offered the option to have airwayplasty under the senior surgeon.', 'Surgeons who did not perform the rhinoplasties can evaluate the results differently from the primary surgeon.', 'Septoplasty is a crucial step during rhinoplasty to correct the nose function and nasal aesthetics', 'Correction of severe short nose is a distressing problem for plastic surgeons .', 'In this clinical trial study, fifty-six patients (56) undergoing rhinoplasty surgery were randomly distributed into two groups (Group E and Group C).', 'The treatment of large , deep , postsurgical nasal tip defects presents a serious problem for skin surgeons and is generally dealt with by using complex flaps or skin grafts .']


Cluster  715
['At our dental education, the examination failure rate amongst students has increased, resulting in subsequent involuntary dropouts', 'The authors collected community-level characteristics from secondary sources for all 947 Iowa incorporated communities to study their relationships with the mean number of general dentists per 1,000 population per square mile (population density), the dependent variable.', 'IFC is a serious and expensive dental health problem affecting about five per cent of children in Simcoe County .', 'The majority ( 56 % ) of these pupils said they visit the dentist when there is a serious dental or oral health problem .', 'However , the high percentage of inactive licensed dentists in Mexico points to a serious problem .', 'Although the postgraduate year training program for dentists ( PGYD ) was implemented in Taiwan in 2010 , the uneven distribution of dentists is still a serious problem .', 'Although population is an important determinant for where a dentist practices, other variables such as urbanization, demographic characteristics, fluoridation status, and presence of at least 1 elementary school are also predictors of the number of dentists in a community.', 'Dentistry and law share a serious problem . A glut of practitioners .', 'In this study, the authors used observational data from 2014 to evaluate the association between the number of general dentists and several community characteristics.', 'Young adults in public dental care with low risk preferred the prepaid model while those in the higher risk categories selected fee-for-service.', 'A comprehensive risk assessment was carried out in 1295 young adults attending eight Public Dental Clinics in the Scania region and 75% could be re-examined after 3\xa0years; 615 had selected the CP model and 310 the traditional FFS.']


Cluster  477
['This retrospective study radiographically evaluated dimensional alterations of the vertically augmented alveolar ridge using collagen membrane and 3 types of materials: autogenous bone block, allogenous bone block, and particulated bone substitute.', 'The alveolar ridge was vertically augmented by 5.', 'GORE DUALMESH is a good synthetic material for diaphragm reconstruction, because its smooth surface prevents adhesions to the lung and its rough surface allows adherence to abdominal tissue.', 'Biosheets may be applied to diaphragmatic repair and replacement of diaphragmatic muscular tissue.', "The authors' new method of alveolar bone grafting with the Scarpa fascia graft is safe and effective, and has one of the highest documented success rates.", 'To compare the healing of allografts and xenografts applied for alveolar ridge preservation.', 'Both grafting materials are suitable for the preservation of the alveolar ridge.']


Cluster  2119
['A total of 196 patients will be randomly assigned to an acupuncture group or a sham acupuncture group at a ratio of 1:1.', 'Fifty-four percent of the participants elected to receive acupuncture.', 'A total of 53% in the true acupuncture group met their criteria for a successful treatment intervention, but this did not differ significantly from the sham group (42%).', "This is the protocol for a randomised, controlled clinical trial with two groups: a 'hand and foot acupuncture with twelve needles' group and a routine acupuncture group.", 'A total of 172 participants diagnosed with PCOS would be randomly assigned to either the acupuncture group or sham-acupuncture group, at a ratio of 1:1.']


Cluster  1355
['In a cross-sectional, observational study, echogenicity of the substantia nigra was assessed in 59 past methamphetamine users and 59 matched controls.', "Current data link methamphetamine abuse in humans to injury of substantia nigra neurons and an increased risk of Parkinson's disease.", 'The average echogenic size of the substantia nigra was larger in methamphetamine users (0.', 'The objective of this study was to investigate structural abnormality of the substantia nigra in past methamphetamine users using transcranial sonography.', "Methamphetamine abuse has been linked to an increased risk of Parkinson's disease."]


Cluster  2194
['Emergent resistance to antibiotics among Streptococcus pneumoniae isolates is a severe problem worldwide .', 'The recent emergence of strains of drug-resistant Streptococcus pneumoniae ( DRSP ) is a serious clinical and public health problem .', 'Streptococcus pneumoniae is a serious public health problem , especially in developing countries , where available vaccines are not part of the vaccination calendar .', 'An abrupt antimicrobial resistance increase among Streptococcus pneumoniae strains has become a serious therapeutic problem in the recent years .', 'Antimicrobial resistance in Streptococcus pneumoniae remains a serious concern worldwide , particularly in Asian countries , despite the introduction of heptavalent pneumococcal conjugate vaccine ( PCV7 ) .', 'Antimicrobial resistance of Streptococcus pneumoniae, especially against β-lactam antibiotics, is a global concern', 'Since this time the increasing emergence of penicillin- resistant strains of Streptococcus pneumoniae have been a serious therapeutic problem .']


Cluster  1216
['It is considered a serious public health problem mainly in tropical and subtropical regions around the world .', 'The disease remains a serious public health problem in endemic countries and affects at least 207 million people worldwide .', 'It is an endemic disease , representing a serious health problem in Latin American countries .', 'It is a serious public health problem in this region of Africa where it is endemic in several countries .', 'The disease represents a serious public health problem in underdeveloped tropical countries .', 'It is in the World Health Organization list of neglected diseases and it is considered a serious public health problem , with more than 20,000 deaths a year and high morbidity .', 'It represents a serious public health problem in Northern America and Europe , which can plague Africa .', 'It is a serious global health problem with an increasing prevalence worldwide .', 'It is a serious public health problem throughout the Mediterranean region , the Middle East and the Indian subcontinent , as well as in Southeast Asia .', 'The disease is widely distributed in Africa , Asia , and Europe and has developed into a serious public health concern .']


Cluster  342
['This study illustrates how to report intervention fidelity in the literature guided by best practice strategies, which may serve to promote fidelity monitoring and reporting in future studies.', 'Although measures of self-reported PA and stage of change suggest the effectiveness of the counselling intervention, the results obtained with accelerometers are contrasting, probably due to the fact that some types of PA participants engaged in could not be recorder by accelerometers.', 'Fidelity assessment of a 4-week intervention protocol in a randomized controlled trial (RCT) with data collection between 2012 - 2016.', 'Seventy-two percent of respondents noted that counseling took place in a counseling center, and 20.', 'Eight participants who had completed the eight-treatment intervention were interviewed.', 'To examine if continuous monitoring of patient progress through the supervision process was more effective in improving patient outcomes compared with giving feedback to therapists alone in routine NHS psychological therapy.', 'Participants (n = 36) completed the Helpful and Hindering Aspects of Therapy (HAT) for each session.', '430 (53%) young women were counseled by the 15 HSAs who received couples counseling training, and 378 (47%) were counseled by the 15 HSAs who did not.', "Telephone counseling could be a cost-effective patient counseling plan for therapeutic adherence after coronary artery bypass surgery in order to improve the patients' quality of life.", 'Attending a greater number of sessions and facing a severe life problem were significantly associated with a worse outcome ( p<0.005 ) .', 'Two independent, trained raters assessed 30 randomly selected treatment sessions involving seven therapists and eight patients who were treated in a multicentre randomized controlled trial.', "The aim of this paper was to report the process evaluation of facilitators' delivery of a psychosocial intervention (called CONNECT), in a randomized controlled trial, to men with prostate cancer and their partners.", 'Findings support the feasibility, preliminary efficacy and efficiency of this five weekly session intervention when applied to a sample of Argentine university students.', 'The study is based on routine healthcare data and tested the hypothesis that telephone coaching in cases of depression leads to a reduction in total healthcare costs.', 'Our training and coaching program successfully trained clinicians to promote patient engagement during therapeutic service delivery, although not typically to 90% or greater adherence.', "To investigate participants' experiences with BA during the pilot phase of the Brief Admission Skåne Randomized Controlled Trial (BASRCT), in order to detect possible strengths and limitations of the intervention and gain knowledge to facilitate implementation of BA at other treatment centers."]


Cluster  1285
['In the present paper sphygmograms were taken under a serious of counter-pressure ( CP ) in order to approach this problem .', 'It also identifies the accumulation of alkali in a region of poor local liquid homogenization as a serious scale-up problem and shows how a change in the addition point significantly reduces it .', 'The resulting displacements can easily amount to several millimetres and as such pose a serious problem for laminar analysis .', 'The problem with this spurious-piston is that it may wrongly be interpreted as a real thickness in any absolute phase measurement .']


Cluster  874
['Mean age of the patients was 44.', 'The mean patient age was 39.', 'Eleven patients were men, and the median age was 60\xa0years (range 44-72).', 'The mean patient age was 57 years.', 'The means of age in the control and the treatment groups were 70.', 'Eight patients were included (five males) with a mean age of 59 years.', 'Thirty-nine patients were included: mean age: 44.', 'The mean age of the fifteen patients included was 74 years.', 'We assessed 7 patients with a mean age of 64.', 'The mean age of the patients was 39 (±\u200915) years and controls were 34 (±\u200911) years.', 'Seventy-three patients were included (median age 8.', 'Patients had a mean age of 71.', 'The age of patients was 82.']


Cluster  24
['This study was a prospective, randomized, controlled study.', 'This was a randomized controlled trial.', 'Randomized clinical trial; Level of evidence, 2.', 'A randomised controlled trial.', 'Non-pharmacological clinical trial.', 'An exploratory randomized controlled trial.', 'This was a prospective randomized controlled trial in a referral center.', 'A randomised, blinded trial.', 'Randomized controlled trial.', 'a randomised controlled study was conducted.', 'A randomized clinical trial.', 'A randomized study was performed.', 'A randomized controlled trial was carried out.', 'Randomised controlled study.', 'The study was designed as a randomized controlled trial.', 'A randomized study.', 'Non-randomized, controlled clinical trial.', 'A randomised study.', 'Randomized controlled trial; Level of evidence, 2.', 'Randomized controlled trial.', 'Randomized controlled clinical trial.', 'Randomized controlled trial; Level of evidence, 1.', 'Randomized controlled trial.', 'A randomized controlled trial.', 'Randomized controlled clinical trial.', 'This was a prospective, randomized controlled trial.', 'Randomized controlled trial.', 'This was a randomized, prospective, investigator-blinded study.', 'Randomized controlled trial.', 'Randomized controlled trial.', 'A blind randomized controlled trial.', 'A randomized study was conducted in a hospital.', 'A prospective randomized clinical trial.']


Cluster  1861
['Twenty-two participants with PD and gait dysfunction were randomized to receive D-ER 10mg twice daily or placebo for 4weeks in a crossover design with a 2-week washout period.', 'This pilot study suggests that a computer-assisted rehabilitation protocol based on executive functions training could improve walking in PD patients with freezing of gait.', 'Patients affected by PD with freezing of gait were treated twice a week for six weeks with one hour sessions of computer-assisted training of attention ability and information processing tasks.', 'The 4-week rehabilitation training program focused on mobility, balance and gait exercises improved balance, gait, physical performance and trunk rotations in patients with PD.', 'Unadjusted comparisons showed significantly higher 6-minute-walk distance, shuttle-walk distance and hand-grip in the PD patients.', 'Physical functioning was measured in 45 prevalent PD patients using standard physical performance measures that include gait speed, chair stand, standing balance, 6-minute-walk, incremental shuttle walk and self-reported PF using the short form (SF)-36 questionnaire.', 'To investigate the UL functioning and activities of daily living in PD patients with PS.', 'A total of 6 patients with PD and PS enrolled in the program of 10 sessions of postural exercise (90\u200amin/session).']


Cluster  609
['Iridovirus infections remain a severe problem in aquaculture industries worldwide .', "The authors concluded that amoxicillin and clavulanic acid is an adequate first-line antibiotic for fish spike injuries but that flucloxacillin may be more appropriate given most bacteria were from patients' own skin flora.", 'Grass carp ( Ctenopharyngodon idella ) hemorrhagic disease , caused by grass carp reovirus ( GCRV ) , is emerging as a serious problem in grass carp aquaculture .', 'Bacterial infections are a serious problem in aquaculture since they can result in massive mortalities in farmed fish and invertebrates .', 'Infectious diseases are a serious problem and a major contributor to severe economic losses in intensive fish culture .', 'Columnaris disease has long been recognized as a serious problem worldwide which affects both wild and cultured freshwater fish including the commercially important channel catfish ( Ictalurus punctatus ) .', 'These are lactococcosis caused by Lactococcus garvieae , which is of economical importance in rainbow trout ( Oncorhynchus mykiss ) ; pseudomonadiasis caused by Pseudomonas anguilliseptica which affects gilthead seabream ( Sparus aurata ) and turbot ( Scophthalmus maximus ) ; and flexibacteriosis caused by Tenacibaculum maritimum which became a devastating problem in the emerging culture of sole ( Solea spp ) .', 'Gray mullet ( Mugilidae ) occur in all seas and are farmed widely around the world , and thus , the risk of their parasites spreading through transport of aquaculture seed is a serious concern .', 'The development of resistance against drugs most commonly used to treat salmon lice is a serious concern for both wild and farmed fish .', 'Infections with koi herpesvirus ( KHV ) in carp are still a severe problem worldwide .', 'Limited availability of sustainable feed ingredients is a serious concern in salmon aquaculture .', 'The bacterium Flavobacterium psychrophilum is a serious problem for salmonid farming worldwide .']


Cluster  951
['Hospital malnutrition continues to be a serious problem .', 'Half of the hospitalized patients in the medical and surgical department of La Rioja are malnourished.', 'Malnutrition is a serious concern in hospitals and is known to be associated with increased complications for patients , increased hospital costs and length of stay .', 'Undernutrition presenting as malnutrition is a serious health concern for frail elderly people with many health problems .', 'Malnutrition in hospitalized patients is a serious problem and is associated with a number of adverse outcomes .', 'Malnutrition in the elderly is a serious problem , prevalent in both hospitals and care homes .', 'Malnutrition remains a severe problem in the recovery of critically ill patients and leads to increased in-hospital morbidity and in-hospital stay .', 'Malnutrition continues to be a serious problem in older adults .', 'It has been recognized that malnutrition in hospital is a serious problem that may go undetected .', 'Undernutrition in hospitalized older adults is increasingly being recognized as a serious problem with implications for both patient care and outcomes and health service utilization and costs .', 'A high prevalence of malnutrition risk was reported among patients accessing health services at public hospitals.', 'Overnutrition as well as undernutrition is a serious problem in hospitalized patients , especially in infants .']


Cluster  893
['Pediatric residents rotating through an inpatient Cardiology rotation were recruited.', 'Potential myocardial damage was found in the endocardium at the basal and papillary levels of the LV in young patients with rTOF, extending from the endocardium to the epicardium and from the base to the apex.', 'Congenital heart disease (CHD) is the most common human birth defect, and clinicians need to understand the anatomy to effectively care for patients with CHD.', 'Included were 12 pediatric to young adult patients with congenital heart (N = 7) or lung disease (N = 5).', 'Myocardial infarction at a young age occurred in 154 (12.', 'The treatment of advanced heart failure ( HF ) in children and infants poses a serious management problem .', 'Approximately a fifth of siblings of young MI patients were found to have asymptomatic but obstructive CHD detected on CCTA of which one third was severe.', 'Prospective observational data was collected on siblings of patients aged ≤55 years presenting with acute MI and having coronary stenosis ≥50% on invasive coronary angiography in at least one epicardial coronary artery.', 'A problem facing doctors treating adults with congenitally malformed hearts is that a significant number of these patients are lost for follow-up .', 'In our population of children with new onset dilated cardiomyopathy, of either viral or idiopathic origin, intravenous immunoglobulins were administered to a minority of the patients and did not influence transplant-free survival, but were associated with better improvement of systolic left ventricular function and with better recovery.', 'We retrospectively evaluated pretransplant clinical and Doppler echocardiographic data for 45 consecutive pediatric LT recipients who were treated between 2007 and 2013 (median age\xa0= 15 months; interquartile range\xa0= 9 to 78 months).']


Cluster  171
['The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills.', 'The primary problem with their study is that it does not consider deterioration to CESR that occurs in CESI patients over time .', 'Despite a relatively large part of the consultation time being spent on SIC, patients received scarce information concerning treatment risks, postoperative period, and who their operating surgeon would be.', 'The main problem with guidelines is that they are rapidly outdated and that the evidence base relies mainly on registration monotherapy trials that hardly reflect treatment in routine clinical conditions .', 'As encountered in other studies relating to trauma , adequate follow-up has been a serious shortcoming .', 'At the end of the treatment, GLSP did not show more encouraging outcomes in symptoms improvement, measured by the ADAS-cog (P\u200a=\u200a.', 'More importantly , these strategies lack customization for personalized patient therapy , which is a significant drawback of these nerve repair options .', 'The use of recall cannot explain why RCTs have not confirmed any benefits from CTOs, and their continued use should be reconsidered.', 'During the follow-up, an unfavorable functional outcome (defined as a mRS score > 2) was found in 219 (30.', 'Furthermore , performance variability remains a vexing problem , with a select group of patients performing poorly despite using the most recent technologies and processing strategies .', 'Lack of a long-term follow-up.', 'A significant problem with large , randomized phase III trials is that improvements in therapy and supportive care can not be rapidly incorporated into treatment , and the question under study may quickly become obsolete .', 'A problem with the BPS model is that it has not been operationalized in terms of patient behavior .', 'Implementation of PBM remains extremely variable across centres.', 'There were significant gaps among the predicted requirement, prescription, and actual delivery of energy and protein in the PICU.', 'One problem with our data is that we do not have patient level information for Medicare patients who did not have a knee replacement during the study period .']


Cluster  956
['A problem with this gradient is that it conflates two key explanations , namely biome stability ( age and area ) and productivity ( ecological opportunity ) .', 'Deer pressure on forest regeneration constitutes a serious problem in commercial forests in the northern hemisphere due to the increase in deer populations .', 'A major drawback of forest succession models is that they often lack physiological details in the simulation of annual tree growth .', 'Contrary to what was suggested by Fox and Ridsill-Smith ( 1995 ) , who misinterpreted some statements in Reddingius ( 1990 ) , the present author thinks this is a serious shortcoming of this test since an ecologist can not assume a priori that important density-independent ecological factors are not somehow serially correlated .', 'The major problem with forest disturbance mapping is that variability between map products leads to uncertainty regarding the actual rate of disturbance .']


Cluster  433
['However , a drawback of previous implementations of this technique arises from it being restricted to 2D .', 'A major problem with such an approach is that a poor initial choice of the functional form may lead to sub-optimal results .', 'A drawback of these procedures is that they can only be applied to the model selection problem at hand .', 'For many years the impossibility of using it to create additional lines was considered a drawback of this approach .', 'However , one problem with the minimal eigenvalue function is that it can be nondifferentiable .', 'However , a major drawback of the Huber regularization is the determining the threshold , which precludes its extensive applications .', 'A general drawback of the bottom-up approach is that the desired structure usually does not represent the global thermodynamic minimum .', 'A major drawback of SVD , however , is the difficulty of designing an incremental solution for the eigenvalue problem .', 'However , the main problem with the EigenSpot method is that it can not be adapted to detect more than one spatiotemporal hotspot .', 'The drawback is that the solution may be only a local optimum']


Cluster  336
['One in 10 young people experiences a distressing sexual problem .', 'It is secondary to several organic , psychogenic , and combined causes , and represents a serious health dilemma affecting both men and their partners .', "Sexual dysfunction is a serious public health problem that affects women 's quality of life .", 'Consecutive Chinese patients (20-55 years) with ED, abnormal nocturnal penile tumescence and rigidity (NPTR), and international index of erectile function-5 items (IIEF-5) score <22 were randomized to receive ESWT or VED (twice weekly, 4 weeks).', 'For males , erectile dysfunction and retrograde ejaculation are well known complications of the disease In addition , the risk of transferring a fatal disease to their offspring is a matter of concern for the patients .', 'ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners .', 'Erectile dysfunction ( ED ) is a distressing problem in hemodialysis patients .', "Sexual dysfunction is currently considered a serious quality-of-life-related health problem , exerting a major impact on patients ' and their sexual partners ' life .", 'Prostatic disease , a preventable and treatable problem , is the most common cause .', 'Male sexual dysfunction is a serious problem which has an impact on the quality of life .', 'Thus , sexual frigidity coupled with dyspareunia was usually a serious problem faced by postoperative patients .', 'Erectile dysfunction ( ED ) is often perceived by both patients and sexual partners as a serious problem that can jeopardize quality of life , psychosocial or emotional well-being , and the partnership in the long term .', 'First , we present the context in which hypoactive sexual desire disorder is defined as a serious medical condition , showing how non-medical and non-scientific influences shaped the understanding of the problem .', 'One problem with most physician and patient surveys is that they have been performed retrospectively , and pretreatment impotence and incontinence prevalent in older men can not be assessed accurately in retrospective studies .', 'Up to half of sexually active older women report a distressing sexual problem , with low desire and problems related to genitourinary syndrome ( vulvovaginal atrophy ) being most common .', 'Erectile dysfunction ( ED ) is a serious public health problem that has a high prevalence and negatively affects the quality of life in elderly men .', 'Until 50 years ago , sexual dysfunction was not regarded as a serious medical problem which is directly responsible for scarce or limited clinical data available on the topic nowadays .', 'Erectile dysfunction and quality of life in type 2 diabetic patients : a serious problem too often overlooked .']


Cluster  522
['Our findings suggest that the <i>ACTN3</i> R577X genotype may influence decline in muscle and bone health phenotypes in older Korean adults.', 'At baseline, there was a difference in thickness of the LM muscles between sides.', 'Stunting and wasting was evident in 12% and 15% of patients, respectively.', 'These results indicate that when delta-amino(14C)levulinate is used to label heme , reutilization is a serious problem in skeletal muscle .', 'The main limitation with the metabolic measurements of anaerobic ATP production from muscle biopsy data is that the active muscle mass is unknown , which makes it hard to accurately study the validity of the MAOD method .', 'Both groups showed shrinkage of bone dimensions.', 'To investigate whether higher muscle coactivation affects standing postural response to perturbation in older adults.', 'Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p< 0.', 'A significant increase in PPT (kg/cm2) was observed in the following muscles in the NW group only: upper trapezius (from 1,32\u200akg/cm2 to 1,99\u200akg/cm2), mid trapezius (from 2,92\u200akg/cm2 to 3,30\u200akg/cm2), latissimus dorsi (from 1,66\u200akg/cm2 to 2,21\u200akg/cm2) and infraspinatus (from 1,63\u200akg/cm2 to 2,93\u200akg/cm2).', 'Thirty-four community-dwelling older participants were randomly assigned either to the coactivation group (CG), where muscle coactivation was increased intentionally, or to the non-coactivation group (NCG).', 'A myofascial trigger point (MTrP) has been defined as a hyperirritable, palpable nodule in a skeletal muscle.', 'The results of the present study suggests that complicated birth or birth trauma may not be the main cause of congenital muscular torticollis and point towards intrauterine and prenatal reasons for its development.']


Cluster  395
['The problem with M5P for accident duration prediction , however , is that whereas linear regression assumes that the conditional distribution of accident durations is normally distributed , the distribution for a " time-to-an-event " is almost certainly nonsymmetrical .', 'Among factors potentially contributing to accidents involving heavy vehicles, reverse alarms can be difficult to localize in space, leading to errors in identifying the source of danger', 'All-terrain vehicle ( ATV ) crashes are a serious public health and safety concern .', 'Collisions between emergency vehicles for emergency medical services ( EMS ) and public road users have been a serious problem , impacting on the safety of road users , emergency medical technicians ( EMTs ) , and the patients on board .', 'Emergency vehicle crashes are a serious nationwide problem , causing injury and death to emergency responders and citizens .', 'Motor vehicle collisions ( MVCs ) resulting in death have been a serious concern for many years .', 'All-terrain vehicles ( ATVs ) on the road : a serious traffic safety and public health concern .']


Cluster  239
['For the past decades , long-term water flooding processes have led to water channeling in mature reservoirs , which is a severe problem in oilfields .', 'Groundwater contamination is a serious problem that is growing in the United States , but its true extent is not known and it is difficult to determine because of the complexities of contaminants , their transformation , and fate in groundwater systems .', 'Water ingress into cracked concrete structures is a serious problem , as it can cause leakage and reinforcement corrosion and thus reduce functionality and safety of the structures .', 'This can become a serious environmental problem , but specific impacts on groundwater are often overlooked in environmental impact assessments of CSPPs and no research on the matter has been reported so far .', 'Water leakage in drinking water distribution systems is a serious problem for many cities and a huge challenge for water utilities .', 'The groundwater quality of southwestern Punjab , India , is a serious cause of concern due to the presence of chemical contaminants in it .', 'Groundwater contamination is becoming a serious problem in many Brazilian regions .', 'Declining groundwater levels is a serious problem in itself and has multiple economic , social , cultural , political , security-related , and environmental externalities .']


Cluster  1621
['Subjects undergoing medical thoracoscopy were randomized 1:1 to receive either intravenous cefazolin 2 g (antibiotic group) or intravenous saline (control group).', 'No beneficial effects and possibly severe adverse events are observed with 3% hypertonic saline in the treatment of bronchiolitis.', 'This study will compare the effects of two sedatives in mechanically ventilated severely septic patients.', 'Paradoxical bronchospasm to salbutamol is a rare situation but can turn into a serious problem for the patient , as well as for the physicians who underestimate this possibility .', 'Against our hypothesis, laryngospasm could still be observed in 18% of children under the higher concentration of sevoflurane (4.', 'Nasopharyngeal excretion volume was significantly higher in the propofol-based TIVA group than in the propofol/sevoflurane group (31.', 'Esketamine effectively countered remifentanil-induced respiratory depression, an effect that was attributed to an increase in remifentanil-reduced ventilatory CO<sub>2</sub> chemosensitivity.', 'Nefopam infusion is effective in preventing and reducing the severity of EA after nasal surgery without a delay in extubation.', 'We are interested in how and why anaesthetics increase infections in intensive care patients ; a serious problem as more than 50 % of patients with severe sepsis will die .', 'Remifentanil reduced isohypercapnic ventilation (end-tidal PCO<sub>2</sub> 6.', 'Airway irritation is a major drawback of desflurane anesthesia .', 'This study explores EDA changes during endotracheal suction in sedated adult critical care patients; and compares these changes to other monitoring parameters.']


Cluster  57
['Lower levels of IFX were associated with ATIs positivity (OR 0.', 'For UUT-UC, NLR is a prognostic factor for PFS and DFS, while LMR is a prognostic indicator for PFS in present series.', 'The mean TTI was significantly shorter in the 60° group than in the 90° group (29.', 'The REG method is biased in the estimation of the proportion of variance explained by QTL , and it may have a serious problem in detecting closely linked QTL when compared to the ML method .', 'Our study suggests that MMT is present if RABQ has GSV values < 500.', 'The regression of TRP/Ccr on 1/(EP/Ccr) was significant.', 'In addition , analysis of outliers in the correlation between the IHC-RS and the Onco-RS reveals the possibility of sampling error as a drawback of the Onco-RS .', 'Mean ERI decreased in the ViE group by 1.', 'The median and optimal cutoff values of ERI and BChE were 6.', 'We found a strong positive linear correlation between maximum QTc interval and cTnI level with a correlation coefficient of 0.', 'Higher median values of aLDH were found (P=0.', 'The Inter-class Correlation Co-efficient (ICC) illustrated that the Farsi version of MSD instruments showed high levels of repeatability.', 'At baseline, cases showed a lower CST FA (0.', 'A significant negative correlation between PNIF-lPNIF-rPNIF and respectively AAR-lAAR-rAAR was found.', "The Spearman's correlation test revealed a positive correlation between the G and the AVQI (r\u202f=\u202f0.", 'There were moderate correlations between TSB and TcB before (r\xa0=\xa00.', 'QTc-max interval has a strong positive linear correlation with cTnI level.', 'Ten features were independently associated with CRC/IBD (all <i>P</i><0.', 'SDMA and sCr had intermediate and low IOI values of 0.', 'Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG.', 'The ADC value was significantly lower in the BA group [(1.']


Cluster  1005
['This study demonstrated the feasibility of an EEC model to investigate CDA-induced clinical responses and pathobiology in NAVMR subjects pre- and posttreatment with AzeFlu.', 'Accordingly , the infiltration of different tissues by macrophages and the inflammatory local and systemic effects observed in ECD likely represent a drawback of OIS .', 'Endothelial barrier dysfunction , which is a serious problem that occurs in various inflammatory conditions , permits extravasation of serum components into the surrounding tissues , leading to edema formation and organ failure .', 'The effect of damage on function was seen in the disease activity-adjusted models using total mSvdHS (p=0.', 'Compared to NDD, EM measured higher LCI, functional residual capacity and cumulative expired volume while respiratory rate was lower.']


Cluster  19
['The MDTMs lasted mean 0.', 'In comparison with the control, there was a statistically significant average reduction in fat thickness measured by calipers at all time points with a 22.', 'Significant decreases occurred in the FBS (-21.', 'Yo-Yo IET performance was considerably lower during the mid LP (2833±896 m) as compared to the early FP (3288±800 m).', 'The XAS score decreased to 3.', 'After 6\xa0months, the final GT increase was 0.', 'At 6 months, the mean FAAM increased from 35.', 'During the final 15 s of ramp exercising with FiO2 0.', 'Peak Wingate power increased significantly over time with NO (889.', 'Significant decrease in the values of Q-T segments (p < 0.', 'Mean improvement was 24.', 'The authors noted a volume decrease between T0 and T15 by 10.', 'Mean luminosity scale gradually decreased from baseline.', 'The mean CAL values were improved from 5.']


Cluster  176
['A problem with many stature estimation methods is that an unknown individual must first be assigned to a specific group before a method can be applied .', 'We suggest that the morphometric standards cannot be universally applied and can demonstrate individual differences.', 'The association of convex facial profile and class II skeletal pattern with Thalassemic status was statistically significant when compared to healthy individuals.', 'We conducted an observational study using a mannequin.', 'This study supports the hypothesis/theory that the different manometric patterns represent different stages in the evolution of the disease-where pattern III is the earliest stage, pattern II an intermediate stage, and pattern I the final stage.', 'A total of 131 casts were randomized and 118 analyzed (37 M, 42 S, 39 W).', 'Observational study using cadaver material and high-resolution computed tomography.', 'As all three measurement methods had either reliability or methodological issues, we found it likely that differences in measurement methods have caused the differences in clavicular length observed in scientific studies.']


Cluster  492
['40 school going children aged 8-10 yrs, randomly allocated into 4 groups (n=10 for experimental group) were asked to rinse with a) Mouthwash prepared from Pomegranate extract, 15 ml twice a day b) Mouthwash prepared from Grape seed extract, 15 ml twice a day, c) Mouthwash prepared from guava extract, 15 ml twice a day, d) Control- Distil water, twice a day.', '[ A serious chewing gum problem ] .', 'Many GUMs available in Indonesia claim to offer nutritional benefits ; however , the current levels of sugar content in GUMs are a serious concern and are inappropriate for inclusion in the diets of young children .', 'Green tea mouth rinse can be a promising preventive therapy worldwide for the prevention of dental caries.', 'Pomegranate, Grape seed and Guava extracts have much been reviewed in Ayurveda and has been proven to have antibacterial action Aim: The objective of the study is to investigate and compare the mouthwash prepared from pomegranate, grape seed and guava extracts on salivary streptococci levels at the end of 48 hr and 7 days, of twice a day usage.']


Cluster  1997
['At 8 weeks, a significant reduction in wart number (P = 0.', 'The proportion of patients achieving PGA treatment success after 8 weeks was statistically significantly greater for CAL/BDP cream (37.', 'Combined treatment of dermaroller and PRP or dermaroller and TCA showed significant improvement when compared with dermaroller alone.', 'All treated groups showed overall clinical improvement as regards the width, texture, and overall improvement after treatment (P > .', 'Both DL and FMR demonstrated steady improvement of acne and seborrhoea during treatment sessions.', 'In the whole cohort, Demodex densities were greater in patients with persistent erythema than in those without.', 'A complete or partial clearing was achieved in all treated areas, and the result was satisfactorily maintained in all cases after a follow-up period ranging from 3 to 36\xa0months.', 'The greatest change was observed after 1 week of treatment.', 'After 2 weeks, the RCM count of papules/pustules and the RCM scores of exocytosis and dermal inflammation, decreased substantially.']


Cluster  542
['The high frequency of IDA is a severe public health problem in developing countries like Egypt , especially in children from rural areas , those from low social class and those of low maternal educational level .', 'Our results indicate that although Isparta is a region with mild iodine deficiency , goiter prevalence remains a serious problem .', 'Overall , despite enormous efforts to control IDDs , still IDD remains a serious public health problem in some countries of the region , requiring urgent control and prevention measures .', 'We conclude that IDD is a severe public health problem in upper Egypt .', 'Although endemic goiter is an easily controlled chronic disease , it continues to be a serious global public health problem .']


Cluster  1535
['A drawback of fluorescence labeling has been the reduced sensitivity relative to that of methods that use enzymes as signal generators .', 'Despite this widespread use , a potential drawback of this probe type is that the ester linkage between the fluorophore and acryloyl recognition unit is liable to be hydrolyzed by abundant esterase in the cytosol , thus affording a high background signal .', 'A comparison between the results of the EPR and fluorescence experiments show the drawback of the fluorescence method in binding studies .', 'A major drawback of labeling with Fluo-3 in combination with the monoclonal antibody MRK16 is the important overlap of emission spectra of both fluorochromes .', 'A commonly encountered limitation with these systems is that the fluorescence induced by SYBR Green ( a fluorophore that binds double-stranded DNA ) can result from primer dimers ( PDs ) as well as the PCR product of interest , thus interfering with the ability to reproducibly quantitate mRNA levels .', 'One problem with fluorescence induction analysis is that most work done to date has used only qualitative or semiquantitative data analysis by visually comparing traces to observe the effects of different chemicals or treatments .', 'However , a potential drawback of detection using chemical probes is the fluorescence background from unreacted or nonspecifically bound probes .', 'However , the problem with studying homomeric receptors is that it is difficult to eliminate the possibility of bound ligands interacting directly with attached fluorophores at the same site .', 'A major drawback of OPA as an analytical reagent is the limited stability of the fluorescent 1,2-disubstituted isoindole .']


Cluster  1905
['We performed a prospective, single arm, pilot trial of laser hair depilation to the natal cleft in 13 patients with pilonidal disease.', 'There are no large volume comparative studies available to compare the efficacy of lasers over lights for hair removal in Fitzpatrick V and VI skin types.', 'We found that alexandrite laser therapy is really effective for treating hirsutism.', 'Laser hair depilation is safe and well tolerated in adolescents with pilonidal disease and may be effective at decreasing pilonidal disease recurrence.', 'Photothermal destruction of hair shaft melanin with intense pulsed light (IPL) and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser has become an effective treatment of hair removal.', "These results suggest that the emerging technology of low-level laser therapy may play a potentially significant role in health care providers' armamentarium for the disease androgenic alopecia."]


Cluster  2198
['We were not able to show whether TAB is superior to MDZ to blunt anxiety in children undergoing ambulatory surgery.', 'Emergence agitation is a serious postoperative problem in children undergoing general anesthesia .', 'According to the results of this study, nitrous oxide has no effect on pupillary diameter of patients under general anesthesia, so it could be safety used, in this regard, in ophthalmic operations.', 'The findings of the questionnaire disclose that the majority of dentists have experienced none of these problems while using nitrous oxide in a professional manner ; however , self-use of nitrous oxide , with its potential neurologic sequelae , may be a serious problem among dental personnel .', 'Sixty children aged 5-10 years showing anxious, uncooperative, and apprehensive behavior were randomly divided and assigned into two groups (Groups A and B) such that Group A received 40% nitrous oxide-60% oxygen and Group B received triclofos sodium in the dose of 70 mg/kg body weight, given 30 min before the treatment procedure.']


Cluster  1625
['Dysphagia is a serious health problem that affects persons of all ages , from the neonate to those of advanced age .', 'Symptoms of dysphonia can be very early evidence of a serious problem , either within the larynx or resulting from a systemic disease .', 'The standard of care for older patients with oropharyngeal dysphagia (OD) is poor.', 'Dysphagia is a serious health problem in aging populations .', 'Dysphagia also causes a severe drawback of the overall quality of life .', 'There was a significant improvement in dysphagia severity scores evaluated by bedside screening tests and FEES in cognitive and total functionality levels except in motor functional independence level in the stimulation group.', 'Dysphagia can be a serious problem in patients with inflammatory myopathies .', 'A major drawback of stents is the occurrence of recurrent dysphagia .', 'It is , however a serious medical problem that may require otolaryngologic intervention because of life-threatening dysphagia and weight loss .', 'For the bulbar ALS/MND patient with dysphagia , the accumulation of oral secretions is a distressing problem .', 'Dysphagia is a serious problem for many patients ; there is a correlation between grade of dysphagia and four QoL dimensions .', 'Although dysphagia is a life-threatening problem in patients with Duchenne muscular dystrophy ( DMD ) , the pathophysiology of oral stage dysphagia is yet to be understood .', 'Definition , prevalence and burden of oropharyngeal dysphagia : a serious problem among older adults worldwide and the impact on prognosis and hospital resources .']


Cluster  2365
['Naturalness and attractiveness can be assessed using video recordings and photographs capturing different facial animations.', 'A well-defined jawline is a critical component in the perception of facial attractiveness in both men and women']


Cluster  603
['Pyometra is a serious problem in dairy cow herds , causing large economic losses due to infertility .', 'Foals on five properties with a Parascaris faecal egg count (FEC)\u2009>\u200950 eggs per gram were used to estimate the FEC reduction (FECR) and efficacy of the anthelmintic combination.', 'Sarcoptic mange is a serious problem in common wombats .', 'Oxidative stress in the mammary gland of high-yielding dairy cows is a serious problem .', 'Sheep of four flocks ( group A ) , in which insufficient lamb growth apparently associated with insufficient milk production and probably related to udder induration , was a serious problem , were clinically examined in mid-lactation .', 'The incidence of attacking or avoiding calves is greater among heifers than among older cows and rejection is occasionally a serious problem .', 'Endometritis in dairy cow herds is a serious economic problem all over the world due to the large economic losses .', 'Hormone treatment promotes calving ease with a markedly reduced incidence of the detrimental effects of dystocia , which may be a serious problem in first-calf heifers .', 'Colic in camelids is considered a severe problem because clinical signs are subtle and often not recognized until the condition is untreatable .', 'Uterine torsion appears to be a serious problem in buffaloes that has certain peculiarities including time of occurrence , site and direction of torsion , and the high mortality rates .', 'In parallel , an increase in some pathological alterations caused by the deficit of some micronutrients present in dairy products , mainly calcium and vitamin D , has been detected , resulting in a serious public health problem in certain groups of population .']


Cluster  1831
['The nonspecific adsorption of proteins and bacteria on the surface of polydimethylsiloxane ( PDMS ) had been a serious concern in a wide range of applications , such as medical devices .', 'Because periprosthetic infection remains a vexing problem for patients receiving implanted devices , we evaluated the effect of several materials on neutrophil free radical production .', 'Bacterial adhesion infection caused by medical materials in clinical application has become a serious threat , and it urgently needs new strategies to deal with these clinical challenges .', 'To overcome these limitations of skin permeation, HO-loaded DMN (HO-DMN) patches were developed and evaluated for their efficacy and safety using in vitro and clinical studies.', 'Synthetic polyurethane and Chitosan-based polymers nasal packs are safe and efficient regarding; the mucosal healing, bleeding control, and the overall satisfaction of patients.', 'Nevertheless , fatal bacterial infections are still a serious problem when CTS nanofibers are used for wound treatment .', 'ZnO-NP-coated socks proved their efficacy in inhibiting the development of PK for military personnel.', 'Bacterial adhesion infection caused by medical materials in clinical application has become a serious threat , and it urgently needs new strategies to deal with these clinical challenges .', 'Foreign body reaction induced by biomaterials is a serious problem in clinical applications .', 'These microbial cells with extracellular polymeric substances \xa0 colonize living and nonliving surfaces and \xa0 pose \xa0 a serious problem for all industries , affecting their processes , leading to a reduction of product quality and economic loss .']


Cluster  820
['Finally we will combine these different tech - sentences that represent persons , locations , organiniques in one probabilistic model in section 7 . zations and dates . annotator bias', 'Finally we will combine these different tech - sentences that represent persons , locations , organiniques in one probabilistic model in section 7 . zations and dates . annotator bias', 'The TempEval shared tasks -LRB- Verhagen et al. , 2007 ; Verhagen et al. , 2010 ; UzZaman et al. , 2013 -RRB- have been one of the key venues for researchers to compare methods for temporal information extraction . it is likely to worsen the generalising power of the model', 'The TempEval shared tasks -LRB- Verhagen et al. , 2007 ; Verhagen et al. , 2010 ; UzZaman et al. , 2013 -RRB- have been one of the key venues for researchers to compare methods for temporal information extraction . it is likely to worsen the generalising power of the model', 'Finally we will combine these different tech - sentences that represent persons , locations , organiniques in one probabilistic model in section 7 . zations and dates . annotator bias']


Cluster  1027
['Lifestyle modification is recommended as the primary intervention for metabolic syndrome (MetS).', 'Metabolic syndrome ( MetS ) which is caused by poor dietary habits and sedentary behavior is a serious global health problem .', 'Metabolic syndrome ( MetS ) is a serious public health problem .', 'Metabolic syndrome is a subclinical status in promoting atherosclerotic cardiovascular disease and type 2 diabetes mellitus', 'Metabolic syndrome is a cluster of pathologies and conditions such as obesity , hyperglycemia , hyperlipidemia and hypertension representing a serious health concern in many countries due to its high rate of mortality and morbidity .', 'A sedentary lifestyle combined with the intake of high-calorie diet has been the paramount cause of metabolic syndrome ( MS ) which is now a serious concern of public health worldwide as it involves the coexistence of hypertension , hyperlipidemia , glucose intolerance , and obesity .', 'The metabolic syndrome ( MetS ) is defined as a cluster of 3 or more metabolic and cardiovascular risk factors and represents a serious problem for public health .', 'The growing prevalence of metabolic syndrome ( MetS ) in the U.S. and even worldwide is becoming a serious health problem and economic burden .', 'Metabolic syndrome ( MS ) is emerging as a serious public health problem in Korea .', 'Metabolic syndrome ( MetS ) becomes a serious society health problem .', 'Metabolic syndrome ( MS ) is becoming a serious global public health problem .', 'OBJECTIVE Metabolic syndrome ( MetS ) is becoming a serious public health concern in many countries , including South Korea , which has faced remarkable changes in lifestyles and disease patterns in recent decades .', 'The high prevalence of the metabolic syndrome is a serious public health problem in Hungary , and remains a major determinant of the high burden of cardiovascular disease .', 'Metabolic syndrome ( MetS ) is a serious public health problem and one of the important risk factors contributing to cardiovascular disease in developed countries .']


Cluster  156
['A crucial drawback of conventional protein structure comparison methods , which compare structures by their main-chain orientation or the spatial arrangement of secondary structure , is that a database search is too slow to be done in real-time .', 'One possible problem with these methods is that they try to predict interacting residues without incorporating information about the partner protein , although it is unclear how much partner information could enhance prediction performance .', 'While various algorithms are available for finding docked conformations , selecting a target function that can reliably score the conformations remains a serious problem .', 'A drawback of the current method is that it requires a time consuming computation due to the exhaustive conformational sampling .', 'Its shortcoming is that it does not capture whether two proteins are arguments of the same binding event , or arguments of two binding events with the same trigger', "Based on the position weight matrix ( PWM ) updating technique , this paper presents a Monte Carlo version of the EM motif-finding algorithm that carries out stochastic sampling in local alignment space to overcome the conventional EM 's main drawback of being trapped in a local optimum .", 'Free-energy calculations for high-dimensional systems , such as peptides or proteins , always suffer from a serious sampling problem in a huge conformational space .', 'X-ray-radiation-induced alterations to protein structures are still a severe problem in macromolecular crystallography .', 'Despite its advantages , a significant drawback of the method has hampered its application to certain classes of problems ; namely , when the chemical structures considered are large and contain heterogeneous ring-systems , the method produces descriptors that tend to merely measure the overall size of the molecule , and begin to lose selective power .', 'Because of the availability of a set of closely related proteins in different crystal environments , the intrinsic drawback of a crystallographic approach was bypassed .', 'This screening is often done by computationally docking ligands into a protein binding site of interest , but this has the drawback of a large number of poses that must be evaluated to obtain accurate estimates of protein-ligand binding affinity .', 'However , this approach found little use in the studies of disordered proteins , where the sampling of vast conformational space presents a serious problem .', 'A drawback of conventional MB design is present in the stem sequence that is necessary to keep the MBs in a closed conformation in the absence of a target , but that can participate in target binding in the open ( target-on ) conformation , giving rise to the possibility of false-positive results .', 'This calculation assumes minimal parsing and maximal reliance on the dictionary . it does not capture whether two proteins are arguments of the same binding event , or arguments of two binding events with the same trigger', 'All of the approaches differ significantly from ours by only attempting to extract the type of interaction and the participating proteins , disregarding agens and patiens . the false positive events that are propagated from the original EE system', 'However , there exists a troublesome problem for designers that some different physicochemical properties have similar vectors of representing 20 amino acids and some closely related physicochemical properties have dissimilar vectors .']


Cluster  2082
["The implant with a silicon backbone layer of 5 - 10 microm was robust enough to penetrate rat 's pia without buckling , a major drawback of polymer alone .", 'Biosheets were prepared by embedding silicone plates in dorsal subcutaneous pouches of rabbits for 4weeks.', "The implant with a 5 microm silicon backbone layer penetrated rat 's pia without buckling , a major drawback of polymer alone ."]


Cluster  1066
['This mode of CO2 release will prevent acidification of the seawater around the release point , which is a major environmental drawback of ocean sequestration of liquid , unemulsified CO2 .', 'Increasing LVAD pump speed from 2 to 4 increased CO from 3.', 'Increased suction levels lead to increased fluid output.', 'To evaluate whether there are advantages of using carbon dioxide (CO2) over air for insufflation.']


Cluster  924
['We conclude that although FUE has many advantages , necrosis of the donor site may be a serious problem .', 'However , a major drawback of large autogenous bone grafts is donor-site morbidity .', 'A drawback of these methods is donor-side morbidity , availability and the shape of the bone .', 'Graft resorption can also pose a severe problem .', 'One problem with some of these grafts is that they lack tensile strength when wet and therefore sink into the cavity left following removal of the meningioma .', 'However , a potential drawback of this technique is the suturing of the urethral margins to the second side of the graft , because the buccal mucosa is already fixed to the corpus cavernosum and the last line is sutured in the back side of the urethra out of sight .', 'As it is a serious cosmetic problem , the need for reconstruction is increasing .', 'However , this approach has a serious problem in that donor organs maintain healthy conditions only during short-term storage .', 'Six months after grafting, 1.', 'The main problem with the majority of these techniques is that they may be associated with significant donor site morbidity due to harvest of some or all of the rectus muscle .', 'At day 14 postoperatively because of a severe psychological problem of the recipient and his wife , the transplanted penis was cut off .', 'With the increase in average life expectancy and growing aging population , lack of functional grafts for replacement surgeries has become a severe problem .', 'Surgical complications remain a serious clinical problem and can lead to loss of graft function .']


Cluster  817
['Infected nonunions resulting in segmental bone loss are a devastating complication for patients and a difficult problem for surgeons .', 'A main drawback of bone block graft surgery is the resorption occurring in early stages of healing .', 'Osseous reconstruction is an important component in ulcer healing and prevention ; however , despite such efforts , major LEAs remain a serious postreconstruction concern .', 'Ectopic bone formation following operations of the hip is a severe problem in traumatology and orthopedic surgery by reason of its high morbidity .', 'We describe a case in which the removal of such a reamer resulted in an iatrogenic intracapsular fracture of the femoral neck , a serious complication of this problem not previously described in the English literature .', 'It represents a serious postoperative problem for the patient , associated with plate breakage and loosening , bone defect , shortening deformity and infection .', 'During primary THA operations conducted from January 2012 to June 2015, a total of 100 patients (100 hips) were confirmed to have an osteophyte-covered TAL following the exposure of the acetabulum and removal of all soft tissues covering the TAL.', 'Severe bone resorption is a vexing clinical problem , especially in patients without teeth .', 'Despite the advancements in bone transplantation operations , inflammation is still a serious problem that threatens human health at the post-implantation period .', 'The percentage of patients in whom the TAL was found using a bone chisel was 54.']


Cluster  2093
['Increased physical activity during exercise intervention was safe in people with mild to moderate dementia.', "To determine whether a dementia-specific motor learning exercise program enables PwD to learn compensatory STS maneuvers commonly taught in geriatric rehabilitation therapy to enhance patients' STS ability.", 'Our results suggest that the spaced retrieval training could decrease the frequency and severity of hyperphagia in patients with dementia.', 'Several observational studies have shown that exercise reduces the risk of cognitive decline; however, evidences from long-term, well-conducted, randomized controlled trials are scanty.']


Cluster  139
['The incomplete and inefficient extraction of tumors with tris buffer system after only one homogenization and centrifugation is a serious concern in efforts to achieve accurate determinations of receptor concentrations which permit the accurate prediction of hormone responsiveness of breast cancers .', 'The amplification smears represent a serious drawback of the method , since they can not be distinguished from the amplification products of normal samples after separation in 1 % agarose gel .', 'In order to remove the complex matrix interference , which resulted in a serious problem during field-amplified sample injection , liquid-liquid extraction was utilized .', 'The problem associated with these types of solid-phase immunoassays is that the adsorption of the primary antibody is desired while the adsorption of other assay proteins is not .', 'These techniques allow for a wide range of applications , like warfare agent detection , chemical reaction control , mass spectrometry imaging , polymer identification , and food safety monitoring , as well as applications in biomedical science , e.g. , drug and pharmaceutical analysis , medical diagnostics , biochemical analysis , etc . Until now , the main drawback of plasma-based techniques is their quantitative aspect , but a lot of efforts have been done to improve this obstacle .', 'A major drawback of protein microarrays is the lack of control of ligand immobilization at the surface of the chip which limits their performances and thus their impacts in in vitro diagnosis .', 'Despite the studies so far about the non-specific binding of antibody molecule to the plastic of solid phase in enzyme-linked immunoassays , background binding in microwell Elisa continues to be a troublesome problem .', 'Two-dimensional gel electrophoresis (2-DGE) is a commonly used tool for proteomic analysis', 'But there is a serious problem concerning fabrication of the microarrays by chemical synthesis , such as specific and efficient linking of probes to a solid support .', 'This allowed EB formation and EB replating to be controlled simultaneously inside a single microfluidic device without pipette-based manual cell retrieval , a drawback of previous EB culture methods .', 'We found high pH reversed-phase fractionation a useful tool to increase assay sensitivity with the drawback of increasing its variability by approximately 10 % .', 'Multiple cross displacement amplification ( MCDA ) , a novel isothermal amplification based molecular detection method , has been developed to overcome the technical drawback of the current methods in recent years .', 'EDN measurements from the BioTracer™ K<sup>®</sup> EDN ELISA Kit correlated well with those from the MBL EDN ELISA Kit: r\xa0=\xa00.']


Cluster  1773
['OCTA helps understand the pathology and disease progression better in MacTel 2.', 'A limitation of the existing methodology for survival analysis with high-dimensional genomic data is that a wealth of structural information about many biological processes , such as regulatory networks and pathways , has often been ignored .', 'ANAT is a graphical, Cytoscape-based tool for the inference of protein networks that underlie a process of interest', 'Chronic inflammatory response, nitric oxide biosynthetic process, microtubule cytoskeleton, cell proliferation and cell migration are regulated by lncRNAs, which also participated in the mainly molecular function and biological processes underlying endothelial dysfunction.', 'We identified various vascular D-OCT features that may aid in non-invasively differentiating subtypes within the keratinocyte skin cancer spectrum.', 'The results showed that distinct or overlapping signaling pathways were involved in CLO, CPO, and CLP.']


Cluster  1519
['The present study was undertaken to evaluate the changing epidemiology of meningitis by reviewing the causative agents, the available laboratory methods for making the etiological diagnosis, the risk factors and the clinical outcomes, and the management of meningitis in our patient population.', 'Meningitis and/or encephalitis can pose a serious public health problem especially during outbreaks .', 'Bacterial meningitis is a serious problem especially in preschool children .', 'Patients with severe meningitis should be admitted to intensive care units and evaluated for ICP monitoring regardless of head CT findings.', 'We conclude that patients with pneumococcal meningitis treated at neurosurgical neurologic centers have different predisposing conditions with severe disease and high mortality, thus prompting us to recommend aggressive pneumococcal vaccination in patients with CSF leaks and severe head trauma.', 'Pneumococcal meningitis , which represents the third in frequency among the purulent forms of meningitis , continues to be , in spite of antibiotic therapy , a serious problem due to its high mortality rate , which reaches 50 per cent in patients of advanced age .', 'We performed a retrospective observational study on the clinical characteristics of consecutively admitted patients with acute pneumococcal meningitis in a single tertiary care center in central Europe (from 2003 until 2015).', 'Neonatal meningitis is a serious problem with a high mortality and frequent neurological sequelae .', 'Given its epidemic potential and development of severe forms of disease , viral meningitis ( VM ) is a serious public health problem .', 'Bacterial meningitis is a serious health concern worldwide .', 'Aseptic meningitis was found to be the predominant type among all different varieties of meningitis.', 'We retrospectively reviewed the cases of patients with diagnoses of pneumococcal meningitis proved by an inflammatory cerebrospinal fluid (CSF) with a positive culture, treated during a period of 14 years at an adult neurosurgical neurologic referral center.', 'Post-traumatic meningitis is a dreadful condition that presents additional challenges , in terms of both diagnosis and management , when compared with community-acquired cases .']


Cluster  356
['Bronchopleural cutaneous fistulas are a serious problem that are difficult to treat with any assurance of success .', 'Vesicovaginal fistula continues to be a distressing problem that results most commonly from urogynecologic surgery .', 'High transsphincteric fistula was found in 44% of the patients, while mid or low transsphincteric fistulas were found in 51%.', 'Our results suggest that OTSC® Proctology is an effective and safe treatment in achieving permanent closure of the internal fistula opening in selected patients, with excellent results in terms of pain, postoperative incontinence, healing time, and days of hospitalization.', 'Constant urinary leakage is a serious social and physical problem accompanying a vesicovaginal fistula in curable and incurable patients .', 'Patients with an anal fistula were evaluated for eligibility in three centres, and randomized to either mucosal advancement flap surgery or collagen plug, with clinical follow-up at 3 and 12 months.', 'CONCLUSIONS We suggest that cholecysto-hydatid fistula is a severe problem that requires close workup with both the radiology and surgery departments .', 'Rectovaginal fistulas present a distressing problem for the patient and a challenge for the treating physician .', 'However , management of high fistulas has long been a serious problem because of the necessity of preserving at least some of the sphincter mechanism .', 'In all 6 patients with outlasting antro-oral fistulas, the defects were healed.', "A retrospective observational study of 59 patients diagnosed with Crohn's disease, who were treated surgically for fistula-in-ano between 2010 and 2014 in our department.", "An ileosigmoid fistula complicating Crohn 's disease of the small bowel has been considered a perplexing entity , but in practice does not pose a serious operative problem .", 'Yet , digestive system fistula as a serious complication still poses a very difficult surgical problem .', "Fistulotomy could achieve good results in terms of wound healing and incontinence in strictly selected patients with Crohn's disease suffering from low-lying transsphincteric fistulae.", 'Rectovaginal fistuale ( RVF ) are a serious and disabling problem for the patients and a surgical challenge for the treating physicians .', 'Genitourinary fistulas are a debilitating problem in females but a comprehensive approach regarding diagnosis and treatment can cure these patients .']


Cluster  169
['Levamisole-contaminated cocaine toxicity is a serious emerging public health concern , and providers should be aware of its presentation and management .', 'Background The dilution or adulteration of urine is a serious problem in drugs of abuse testing .', "This is a serious public health and social problem throughout the world and it is highly challenging to identify which SC was consumed by the drug abusers , a necessary step to tie adverse health effects to the new drug 's toxicity .", 'Nonmedical sedative use is emerging as a serious problem in India .', 'Pneumothorax in drug abusers is a serious urban problem and one with which physicians need be familiar .', 'BACKGROUND : Infected false femoral aneurysm ( IFFA ) is a life-threatening complication of intravenous drug abuse and presents a difficult management problem for the vascular surgeon .', 'Although tramadol is thought to have low abuse and dependence potentials worldwide , its abuse has become a serious problem in many countries , particularly in the Middle East , Africa , and West Asia .', 'A total of 6806 cases of unintentional epinephrine auto-injector exposures were reported to US Poison Centers in 2013 and 2014.', 'As its unique effects of inducing the dissociative hallucinatory , vivid dreams , out-of-body experiences , and delirium , it has diverted from legitimate uses to the illicit drug market , and abusing ketamine has become a serious social problem .', 'Confusion about epinephrine dosing leading to iatrogenic overdose : a life-threatening problem with a potential solution .', 'A drawback of the immediate-release formulation of tramadol ( four-times-a-day dosing ) might be addressed by an extended-release formulation .', 'We found high levels of nonrational drug use in the NISSRP system in both 1996 and 1999 , indicating a serious ongoing problem .', 'The easy access to large quantities of the drug and the widespread perception that the drug is harmless have contributed to salicylate intoxication becoming a serious and common problem , particularly among the pediatric and geriatric populations .', 'Chronic use of sedatives is prevalent and persistent among older adults in British Columbia.', 'Acute voluntary medicinal intoxications ( AVMI ) constitute a serious social-medical problem , frequently related to other problems , such as drug addiction and psychopathies .']


Cluster  80
['Spittlebugs annually infest pastures and cause severe damage , representing a serious problem for the tropical American beef cattle industry .', 'Hypersensitivity to the imported fire ant continues to be a serious problem in the southern United States and appears to be amenable to properly instituted hyposensitization therapy .', 'Resistance to these insecticides in Aedes aegypti is a serious problem for the control of this species therefore integrated management strategies were proposed to prevent or delay the appearance of this species in Cuba and Venezuela .', 'The invasive brown marmorated stink bug , Halyomorpha halys ( Stål ) , has become a severe agricultural pest and nuisance problem since its introduction in the U.S. Research is being conducted to understand its biology and to find management solutions .', 'Rhynchophorus ferrugineus ( Olivier 1790 ) ( Coleoptera : Curculionidae ) is becoming a serious problem in Mediterranean areas where it is well-adapted , and now is present even in the United States ( California ) .', 'Prevalence rates were highest in the four western-most communities , where the vector , Culicoides phlebotomus , is a severe nuisance problem .', 'Since there is no effective control application against this pest , it has been a serious problem up to now .', 'The use of traditional control methods has been only partially successful and tick infestations remain a serious problem .', 'Black flies , a non-target species of the insecticides used in fruit production , represent a severe medical and veterinary problem .', 'The navel orangeworm , Amyelois transitella ( Walker ) ( Lepidoptera : Pyralidae ) , is the most destructive lepidopteran pest of almonds [ Prunus dulcis ( Mill . ) D.A.Webb ] and pistachios ( Pistacia vera L. ) in California and is a serious problem in figs ( Ficus carica L. ) and walnuts ( Juglans spp . ) .', 'The development of pyrethroid resistance in Aedes aegypti ( L ) ( Diptera : Culicidae ) is a serious concern because major A. aegypti control programs are predominantly based on pyrethroid use during epidemic disease outbreaks .', 'Some African flies may cause myiasis not only in animals but also in humans , representing a serious health problem for the local population and for tourists .', 'Even though control measures have been taken , O. megnini infestation is a serious problem for the stable owners especially because these horses are used in racing and other recreational purposes .', 'Mass attacks by Hymenoptera have become a serious public health problem in tropics .', 'It has not been detected in the United States yet , but given the extent of trade with Asian countries , eventual arrival of this beetle is a serious concern .']


Cluster  1425
['Seventy patients were included in the study.', 'Forty-seven patients completed the study.', 'A total of 67 patients completed the study.', 'Seventy-seven patients were followed up.', 'Of the 81 patients enrolled, 72 completed the study.', 'A total of 702 patients were included in the current analysis.', '78 completed the study.', '75 patients completed the study.', 'There were 704 patients analyzed.']


Cluster  460
['Used engine oil ( UEO ) constitutes a serious environmental problem due to the difficulty of disposal off or reuse .', 'Unfortunately , the increasing market demand towards virgin olive oil could often result in its adulteration with less expensive oils , which is a serious problem for the public and quality control evaluators of virgin olive oil .', 'Emulsified oil in wastewater constitutes a severe problem in the different treatment stages .', 'Accordingly , the aim of this research work was to evaluate strategies for the development of a virgin olive oil enriched with phenolic compounds obtained from olive cake to increase phenolic ingestion without the drawback of a higher calorie intake .', 'The adulteration of extra virgin olive oil ( EVOO ) with hazelnut oil ( HO ) is frequent and constitutes a serious concern both for oil suppliers and consumers .', 'Adulteration of diesel oil by kerosene is a serious problem because of air pollution resulting from car exhaust gases .', 'The illegal cooking oil has become a serious social problem and raised widespread alarm recently .', 'Illegal cooking oil ( ICO , also named swill-cooked dirty oil ) has recently become a serious food safety problem in China .', 'Lipid oxidation is a serious problem for oil-containing food products because it negatively affects shelf life and nutritional composition .']


Cluster  2040
['Gene therapy is expected to be used for the treatment of peritoneal fibrosis , which is a serious problem associated with long-term peritoneal dialysis .', 'Peritoneal fibrosis ( PF ) , a serious problem in long-term continuous ambulatory peritoneal dialysis ( CAPD ) patients , is characterized by extracellular matrix ( ECM ) accumulation which results from an imbalance between the synthesis and the degradation of ECM components .', 'Renal fibrosis is a serious clinical problem resulting in the greatest need for renal replacement therapy .', 'Fibrosis of the peritoneal cavity remains a serious , life-threatening problem in the treatment of kidney failure with peritoneal dialysis .']


Cluster  339
['Americans do exhibit some differences , placing lower priority on the environment and global warming , and with fewer believing that " global warming has been established as a serious problem and immediate action is necessary " .', 'Observed numbers of visitors were relatively low and duration of visits were short, which seemed to indicate visitors were trying out the landscape.', 'This study will provide information on the impact of participation in a community garden on the different dimensions of sustainability, based on a robust quasi-experimental design allowing causality evaluation.', 'We observed the number of spontaneous visitors as well as the duration of visits, changes to another location within the landscape, and adopted postures.', 'This research explores the extent to which attitudes towards an environmentally-friendly topic (a green company) are affected by a &ldquo;tip of the tongue&rdquo; (TOT) experience']


Cluster  1798
['The walking program is an effective intervention for improving the subjective and objective sleep quality of lung cancer patients and can be considered an optional component of lung cancer rehabilitation.', 'Growing number of elderly lung cancer patients reflecting a lengthening life span has become a serious problem .', 'Continuous nursing based on Omaha System theory can ameliorate cancer fatigue in patients with lung cancer undergoing chemotherapy.', "The psychological nursing and health education implemented for elderly patients with lung cancer will improve patients' bad mood effectively, enhance life quality and perfect prognosis for patients, maintaining significant value in clinical application.", 'This trial investigated the effects of a 12-week exercise intervention including home-based walking exercise training and weekly exercise counseling on 111 lung cancer patients.', 'Multidisciplinary rehabilitation in irradiated prostate cancer patients retained the adjustment style Fighting Spirit stable after six months of radiotherapy, and in the long term reduced Cognitive Avoidance.']


Cluster  1766
['To characterize the mg/kg dosing differences between pediatric ED patients who respond to an initial dose of ziprasidone versus patients who do not.', 'Forty children received 50 doses of IM ziprasidone.', 'This was a retrospective, observational study of 5- to 18-year-old patients who were treated with IM ziprasidone in the pediatric ED from 2007 to 2015.']


Cluster  1198
['The presence of mycotoxins in food represents a severe threat for public health and welfare , and poses relevant research challenges in the food toxicology field .', 'Contamination of food with mycotoxins and the associated possibilities of human intoxication is a serious problem in Africa .', 'Human exposure to these mycotoxins is a serious problem especially in developing countries where hot and humid climates favor the fungal growth and where food storage conditions are poor and lack of regulatory limits enforcement .', 'Mycotoxin contamination in pet food poses a serious health threat to pets , causing an emotional and economical concern to the pet owners .', 'Mycotoxin contamination of crops is a serious problem throughout the world because of its impact on human and animal health as well as economy .', 'Contamination of feed with mycotoxins represents a serious worldwide problem concerning animal health and related economic losses .', 'Hundreds of potentially toxic mycotoxins have been already identified and are considered a serious problem in agriculture , animal husbandry , and public health .', 'Contamination of food/feedstuffs by mycotoxins is a serious problem worldwide , causing severe economic losses and serious health problems in animals/humans .']


Cluster  1611
['We use the preposition de to link genus term and other potential terms due to its importance to produce lexical relations of our interest . a deviation between two scanpaths in one fixation leads to an increase of the dissimilarity of 1 irrespective of whether the deviation is spatially large or small', 'We use the preposition de to link genus term and other potential terms due to its importance to produce lexical relations of our interest . a deviation between two scanpaths in one fixation leads to an increase of the dissimilarity of 1 irrespective of whether the deviation is spatially large or small', 'We use the preposition de to link genus term and other potential terms due to its importance to produce lexical relations of our interest . a deviation between two scanpaths in one fixation leads to an increase of the dissimilarity of 1 irrespective of whether the deviation is spatially large or small']


Cluster  1061
['Of 220 randomized and treated subjects, 119 receiving a single aprepitant dose were sampled for PK analysis and had evaluable aprepitant plasma concentrations.', 'Based on these metabolism data, aprocitentan can be concomitantly administered without dose adjustment with drugs that are inhibitors or inducers of any metabolizing enzyme, specifically cytochrome P450 enzymes.', 'Measurable plasma concentrations were observed in 78% of subjects after the treatment.', 'This article assesses the relationship between plasma dabigatran concentration and coagulation assay results across age groups in children and adults.', 'To investigate safety, tolerability, mass balance, absorption, distribution, metabolism, and excretion of aprocitentan.', 'Significant differences between groups I and II were observed regarding the use of enoxaparin (75.', 'The increase in plasma levels of motilin (administration; P=.', 'The exploratory analysis showed that the 90% confidence intervals of geometric mean ratio (Treatment B/Treatment A) for maximum plasma concentration (C <sub>max</sub>), area under the plasma concentration-time curve from zero to infinity (AUC<sub>0-∞</sub>) of ACT-333679, as well as AUC<sub>0-∞</sub> of selexipag, were within the bioequivalence interval (0.']


Cluster  2377
['Laser induced damage of fused silica is a serious problem for high power laser systems , and damage precursors are mainly induced by manufacturing processes .', 'For precision optical systems , the focus and tilt errors caused by coating thickness nonuniformity can be a serious concern .', 'Recently , optical surfaces with 0.1 \u2005 nm micro-roughness and 0.05 \u2005 µrad slope error ( r.m.s . ) have become commercially available and surface distortions due to heat load have become a key factor in determining beamline performance , and heat load has become a serious problem at modern synchrotron radiation facilities .', 'Coating degradation was not a serious problem in room temperature external cavity laser operation .']


Cluster  2171
['Ofloxacin quality control zone diameter ranges for the disk diffusion test are tentatively proposed , but variations in the performance of different lots of Mueller-Hinton agar may prove to be a serious problem for users .', 'Grape seed proanthocyanidin extract (GSPE) has a certain resistance to contrast light, which makes the boundary of the imaging image unclear', 'As promastigotes are non-adherent , application of the MTT assay in its original form has a major drawback of a high and variable background absorbance due to incomplete removal of phenol red , a component of most media .', 'A frequently reported drawback of ethylene vinyl alcohol copolymer-based liquid embolic agents is the production of artifacts in diagnostic imaging .', 'The dependence of the assay results on the cell integrity might be a major drawback of the MTT assay application for the evaluation of novel antimicrobials against Gram-negative microorganisms .']


Cluster  1059
['Outside Europe . Is poliomyelitis a serious problem in developing countries ?-- the Danfa experience .', 'Is poliomyelitis a serious problem in developing countries ? The Vellore experience .', 'Vaccine-associated paralytic poliomyelitis is a serious concern while using the live attenuated oral polio vaccine for the eradication of poliomyelitis .', 'Sixty-five poliovirus strains were investigated in genetic marker tests in order to obtain information on the characteristics of polioviruses circulating in Uganda where , owing to the insufficient use of live poliovirus vaccine , poliomyelitis remained a serious public health problem .', 'The findings show that paralytic polio is a serious problem in our country where poliomyelitis is endemic : this is contrary to the views generally held so far .']


Cluster  767
['Space motion sickness ( SMS ) remains a troublesome problem during spaceflight .', "Astronauts' orientation preferences tend to correlate with their susceptibility to space motion sickness (SMS).", 'Atrophy of skeletal muscles is a serious problem in a microgravity environment .', 'Bone loss induced by microgravity is a serious problem in space flight .', 'Postflight orthostatic intolerance has been identified as a serious biomedical problem associated with long-duration exposure to microgravity in space .']


Cluster  1602
['Resistance to steroid hormones presents a serious problem with respect to their mass use in therapy .', 'Sport and doping are a contradiction in terms , however , doping abuse in sports has been a serious problem for many years .', 'The supply of human growth hormone now available to athletes seems small and costly , but drug testing experts agree that abuse of the substance could become a serious problem , especially if synthetic hormone becomes more widely available .', 'Anabolic ergogenic substance use , in particular the use of anabolic androgenic steroids , is a serious problem in general .', 'Application site reactions , a major drawback of testosterone patches , occur less frequently with testosterone gels .']


Cluster  852
['An obvious drawback is that it is necessary to re-classify many words if the application domain changes significantly', 'However , an obvious drawback is that the actual lexical information gets lost in favor of marking IGs , preventing the potential usage of that information in deciding on inter-word dependencies', 'It has many positive features , but one drawback is that it does not provide estimates of class membership probabilities', 'A fundamental drawback is that phrases are translated and reordered independently of each other and contextual information outside of phrasal boundaries is ignored', 'The main drawback is that the entries produced automatically need some semimanual checking', 'The only drawback is that it willperform slower as it needs to process all the words', 'Another major drawback is that it requires considerable linguistic skill to produce proper rules in a proper order', 'One drawback is that it cannot deal with dependencies of higher order of TU n-grams than bigrams', 'The drawback is that the complexity in syntactic processing is coupled with semantic parsing and makes the latter even harder', 'A drawback is that these features give no information about where in the string the n-grams should occur', 'However , one disadvantage is that the reliability of the rules is often language pair dependent']


Cluster  1136
['Violence in men represents a global health burden and a serious problem of public health , with severe repercussions on physical , psychic and social health .', 'It is concluded that the prevalence of sexual violence among high school students is a serious problem and concern .', 'Violence against women is a serious public health problem .', 'Rape is a serious concern globally .', 'These variables are what make violence against women a preventable problem .', 'Violence against women by their male partners is a serious public health problem that has not been adequately addressed by the medical and psychiatric professions .', 'Attitudes which condone violence and a serious problem of alcohol-related , male-on-male violence are key targets for preventive interventions among British men .', 'Sexual violence is a serious public health problem which is common around the world .', 'It was observed that health professionals characterize violence against women as a severe and important problem in society , caused by and leading to gender inequality .', 'Violence against women ( VAW ) is a serious public health and human rights concern .', 'Gender-based violence ( GBV ) is a serious global public health problem that becomes aggravated during public health emergencies that involve quarantine measures .', 'Sexual violence against women is a form of gender violence and both a severe human rights violation and public health problem .', 'Violence against women is widely recognized as a serious public health problem in the world .']


Cluster  2261
['This is a serious problem .', 'is a serious concern .', 'This is a serious problem to overcome .', 'This is a serious problem .', 'This has been a serious concern .']


Cluster  1193
['Spontaneous supratentorial intracerebral hemorrhage is a vexing clinical problem .', 'Best evidence in anesthetic practice : recombinant activated factor VII for acute intracerebral hemorrhage : a promising therapy for a devastating problem ?', 'Brain edema induced by intracerebral hemorrhage ( ICH ) is a serious problem in the treatment of ICH .', 'Intraventricular hemorrhages (IVH) are a potentially fatal diagnosis that must be managed properly to avoid devastating complications', 'Intracerebral hemorrhage ( ICH ) is the common brain diseases in middle-aged and elderly people , with high disability and/or mortality rate , and is a serious public health concern .', 'Intracerebral hemorrhage ( ICH ) is a serious public health problem which causes high rates of disability and mortality in adults .', 'The significance of white matter lesions (WMLs) in intracerebral hemorrhage (ICH) remains unclear.']


Cluster  3
['Soil erosion is a serious environmental problem .', 'Rangeland degradation has been identified as a serious concern in alpine regions of western China on the Qinghai-Tibetan plateau ( QTP ) .', 'Soil erosion is a serious problem in areas with expanding construction , agricultural production , and improper storm water management .', 'Soil erosion has become a serious problem in recent decades due to unhalted trends of unsustainable land use practices .', 'Wind erosion is a primary cause of desertification as well as being a serious ecological problem in arid and semi-arid areas across the world .', 'Soil erosion is a severe problem for many developing regions that lack adequate infrastructure to combat the problem .', 'Development and land use change lead to accelerated soil erosion as a serious environmental problem in river catchments in Iran .', 'Due to the fragility of the natural environment and overexploitation of land by the local people , desertification is becoming a serious problem in the valleys .', 'Soil degradation through erosion and desertification reduces soil productivity , and is a serious problem in agricultural production of China .', 'Overgrazing is a severe problem in several regions in Northwestern China and has caused serious land degradation .', 'The risk of the desertification of a part of Romania is increasingly evident , constituting a serious problem for the environment and the society .', 'Soil erosion and both its on-site and off-site impacts are increasingly seen as a serious environmental problem across the world .', 'Such erosion has become a serious problem in China .', 'Soil erosion caused by wind is a serious environmental problem that results in land degradation and threatens sustainable development .', 'Soil desertification has become a serious problem that endangered sustainable development in the ecotone .']


Cluster  2357
['Fifty obese female adolescents were randomly divided into two groups: exercise plus dieting group (n=30) and dieting group (n=20).', 'Obesity remains a serious health problem for the Croatian population ; the alarming rates of excess body weight continue to increase .', 'A cohort of adolescent and young adult males with severe childhood-onset obesity (n = 21, mean age 18.', 'Obesity and fatness , but also underweight , is a serious problem in Swiss adolescents .', 'General practitioners (GPs) were consulted more often by overweight (incidence rate ratio (IRR): 1.', 'Our study highlights the need for effective weight management given that overweight and obese youth consult their GP more often.', 'Dutch Obesity Clinic West; private practice and the Leiden University Medical Center, the Netherlands; university hospital.', 'To identify health profiles of underweight, overweight and obese young people attending general practice and compare them to normal-weight youth and also to explore the weight-related health risks of eating and exercise behaviour in the four different weight categories.', 'The prevalence of adolescent obesity has increased considerably over the past decade in Switzerland and has become a serious public health problem in Europe .', 'Of the 50 patients the majority were young adults with degrees of obesity between III and IV.', 'Obese adolescents (n=40; mean body mass index [BMI] 35.', 'In this observational study, body composition was measured by dual energy x-ray absorptiometry (DXA) in 663 male and female overweight and obese children at baseline within a multidisciplinary, pediatric fitness clinic at an academic medical center.']


Cluster  2053
['23 Patients aged 21 - 52 with insulin dependent diabetes mellitus ( seven with symptoms suggesting autonomic neuropathy , nine with a serious clinical problem with hypoglycaemia , and seven without symptoms of autonomic neuropathy and without problems with hypoglycaemia ) and 10 controls with a similar age distribution , without a personal or family history of diabetes .', 'Twenty eighth patients with diabetic neuropathy (40-55 Y/O) participated in this RCT study.', 'We conducted a one-way crossover cohort study comparing intensive medical treatment and islet cell transplantation for type 1 diabetes on the change in nerve conduction velocity over six years.', 'The CSAs of the examined nerves in diabetic patients were larger than those in healthy individuals (p< 0.', 'Islet cell transplantation improves nerve conduction velocity and could be further investigated as a treatment for neuropathy in type 1 diabetes.', 'To evaluate the correlations of the cross-sectional area (CSA) of peripheral nerves in diabetic peripheral neuropathy (DPN) patients based on ultrasound (US) with clinical and demographic characteristics.', 'To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with diabetic neuropathy.', 'Neuropathy is a common diabetic complication that can result in significant disability.']


Cluster  954
['Informed consent , which is a key component of patient rights , is also reflected , however , to date , a significant drawback of the Azerbaijan medical legislation is described in the article in this field .', 'Behind them is a serious concern with the type and scope of medicalisation in modern society as well as its sociological criticism .', "Lack of control for patients' prior surgery or self-education is a limitation.", 'In the opinion of the authors, the described facts illustrate how legal regulations that should protect vulnerable groups in medical research, in a\xa0specific case can lead to the fact that a\xa0therapy form relevant to the corresponding patient group cannot be scientifically investigated.', 'Fundamentally , the problem with premature consent patients is that certain of their evaluative bases are not open to revision .', 'It is argued that a major problem with the private sector models introduced in New Zealand is that they fail to recognise the levels of uncertainty inherent in the diagnosis and treatment of illness .', 'We conclude that we can still not reliably predict serious handicap and we are therefore faced with a serious ethical dilemma which we think can best be approached in a trust-relationship between parents and staff .', 'It can be summarized as follows : 1 . We have to acknowledge the presence of a serious credibility problem , which might undermine the foundations of medical science .', 'A serious problem currently plaguing the medical field is the widening gap between academic medicine , which studies the features and causes of illness , and the medical care that patients desire .', 'At present , the increasing trend of medical disputes has become a serious problem in the work of medical institutions , and directly affects the social stability and orderly development of the institutions .', 'Initial denial by some health professionals that there was a serious problem was replaced by critical self-assessment within the provincial government , hospitals and medical and nursing schools , who made commitments to reform hospital practices and the medical school curriculum .', 'A problem with the current law is that doctors who follow current best practice can not be confident that they will be protected from criminal prosecution .', 'Controversy in medicine is inevitable , but it becomes problematic when the issue is a serious public health problem requiring a clear plan of action .', 'The drastic decrease in post-operative functional autonomy in such patients might become a serious socio-economic and welfare policy problem .']


Cluster  120
['Eighty-four client-owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy.', "Excessive barking can be a mild annoyance or a severe problem , particularly if the owner is under pressure from other people to stop the dog 's behavior .", 'Doxepin did not appear to improve any measures of owner-assessed quality of life in Labrador retrievers with laryngeal paralysis.', 'Doxepin will improve quality of life measures assessed by owners of Labrador retrievers with laryngeal paralysis not requiring emergency surgery.', 'To evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE.', 'To evaluate otic treatment administered by a veterinarian on quality of life (QoL) of dogs with otitis externa and their owners, and on clinical and cytology parameters of otitis; compared to an owner-administered treatment.', 'Twenty-two Labrador retrievers with laryngeal paralysis.', 'Thirty client-owned dogs with otitis externa.', 'Based on the findings of this study, preanesthetic oral administration of gabapentin significantly prevents an increase in the IOP associated with tracheal intubation in dogs anesthetized with propofol.']


Cluster  1995
["Cushing 's syndrome caused by ectopic secretion of adrenocorticotropic hormone ( ACTH ) is often a serious disease and a diagnostic dilemma .", "Finally , physicians caring for these patients need to recognize that Cushing 's disease is a debilitating problem that should be managed aggressively ; expecting chemotherapy to solve this complication is not appropriate .", 'A retrospective cohort study, including children who underwent surgery due to CS (n = 115), was divided into children with a pituitary adenoma (Cushing disease) (n = 88), primary adrenal CS (n = 21), or ectopic adrenocorticotropin- or corticotropin-releasing hormone (ACTH-/CRH)-secreting tumors (n = 6).']


Cluster  2332
["The internalization of CPAP service represents significant cost savings from a hospital perspective and an improvement in patients' perceptions of the quality of service.", '45% consider that the PR during CPR is not demanded by users.', 'To discover the opinion of health professionals on the PR during CPR.', 'Potential CPAP patients were identified in the Advanced Paramedic Clinical Activity Study (APCAS) database and then followed up in the receiving hospital emergency department (ED) and medical records.']


Cluster  400
['The presence of Alicyclobacillus , a thermoacidophilic and spore-forming bacterium , in acidic fruit juices poses a serious problem for the processing industry .', 'The problem with these two approaches is that they are either overly inclusive ( i.e. , detect all bacteria of a given species regardless of spoilage potential ) or overly selective ( i.e. , rely upon individual , putative spoilage-associated genes ) .', 'The fermentation of industrial bacteria encounters a serious problem in continuous culture , i.e. the production traits lose .', 'The presence of Alicyclobacillus acidoterrestris , a thermoacidophilic and spore-forming bacterium , in pasteurized acidic juices poses a serious problem for the processing industry .', 'Bacteriophage infection in dairy fermentation constitutes a serious problem worldwide .', 'Bacteriophages are recognized as a serious problem in industrial fermentations ; however , YS61 differed from many virulent phages associated with food fermentations since it was difficult to propagate and was very susceptible to resistance development .', 'Microbial contamination of alcoholic fermentation processes ( e.g. winemaking and fuel-ethanol production ) is a serious problem for the industry since it may render the product unacceptable and/or reduce its productivity , leading to large economic losses .', 'Contamination of bacteria in large-scale yeast fermentations is a serious problem and a threat to the development of successful biofuel production plants .']


Cluster  578
['Twenty four pain-free individuals with sleep bruxism were randomly assigned to either an intervention group or a control group.', 'A combination of rehabilitation and mattress overlay use seems an effective approach for improvement of pain, perceived back disability, sleep, spine mobility, and lumbar multifidus size and structure of LBP patients.', 'Sleep disorders should be routinely evaluated and treated in low back pain (LBP) patients because they represent an important contributor to pain.', 'The severity of SDB was assessed before surgery using a portable sleep monitor.', 'Fifty-seven women completed questionnaires about insomnia, climacteric symptoms, and pain.', 'To study associations of sleep quality with pain, depression and disease activity in RA.', 'Insomnia status affected climacteric symptoms and pain interference, but not pain intensity in postmenopausal women.', 'Most of RA patients do not have a good sleep quality.', 'Postmenopausal women with insomnia had statistically significant higher pain interference in their activities (e.g. relationships with other people, enjoyment of life and sleep) than controls, and had more severe climacteric symptoms.']


Cluster  1716
['Cork taint in wine is a serious problem which is exacerbated by the difficulty of its assessment .', 'This is an off-flavor that is a serious problem for the wine industry .', 'The formation of haze is a serious quality problem in beer production .', 'Brettanomyces bruxellensis spoilage is a serious problem for the wine industry .', 'Protein haze remains a serious problem for the wine industry and requires costly bentonite treatment , leading to significant wine volume loss .']


Cluster  399
['Aedes spp . mosquitoes mainly transmit the arboviruses dengue virus ( DENV ) and chikungunya virus ( CHIKV ) in urban areas , causing a severe public health problem .', 'Because the mosquito vector Aedes albopictus is present in habitats across Europe , North America , and East Asia , CHIKV has become a serious worldwide public health concern .', 'Mosquito-borne viral infections are becoming common and a serious public health problem in DRC .', 'Mosquitoes constitute a severe health problem in many areas all over the world .', 'Mosquito control is a serious concern in developing countries like India due to the lack of general awareness , development of resistance , and socioeconomic reasons .', 'The unavailability of a vaccine and of anti-viral drugs has made this mosquito-borne disease a serious health concern .', 'Mosquitoes in Habahe County of Xinjiang Uigur Autonomous Region in China are considered a serious nuisance problem to local residents , but little is known of their role in enzootic disease .', 'TDengue is one of the most important arboviruses affecting man and is a serious health problem in tropical areas where climatic conditions are favorable for occurrences of foci of Aedes aegypti .', 'Mosquito-borne diseases are a serious global problem , particularly in tropical and sub-tropical countries such as Nepal .', 'The problem with chemical control of these mosquitoes is that the breeding sites are always well dispersed and not easily located , and more manenergy and money are required to treat them individually .', 'Aedes aegypti , commonly known as " the yellow fever mosquito " , is of great medical concern today primarily as the major vector of dengue , chikungunya and Zika viruses , although yellow fever remains a serious health concern in some regions .', 'West Nile Virus has quickly become a serious problem in the United States ( US ) .']


Cluster  540
['PM in ambient air arises from industry , local heating , and vehicle emissions and poses a serious problem mainly in large cities .', 'The rise in particulate matter ( PM ) concentrations is a serious problem for the environment .', 'Particulate air pollution is becoming a serious public health concern in urban cities in India due to air pollution-related health effects associated with disability-adjusted life years ( DALYs ) and economic loss .', 'It is evident from the past studies that dust fallout is a severe concern due to its impact to urban air quality and public health .', 'Airborne particulate matter ( APM ) is a major air pollutant , and the effect on human health of fine APM ( PM2.5 ) deposited deep inside the lungs has recently become a serious concern .', 'Particulate pollution is currently regarded as a severe environmental problem , which is intimately linked to reductions in air quality and human health , as well as global climate change .', 'PM2.', 'Dust pollution has become a serious environmental problem especially in recent decades .', 'Coarse particulate matter with aerodynamic diameter between 2.5 and [ Formula : see text ] ( [ Formula : see text ] ) air pollution is a severe environmental problem in developing countries , but its challenges to public health were rarely evaluated .', 'Particulate matter pollution is a serious environmental problem .', 'Recent years , air pollution has been a serious problem , and PM', 'Particulate matter ( PM ) pollution is a serious concern for the environment and public health .', 'Particulate pollution is a serious health problem throughout the world , exacerbating a wide range of respiratory and vascular illnesses in urban areas .', 'Fine particulate ( PM2.5 ) is a severe problem of air pollution in the world .', 'Particulate pollution has emerged as a serious environmental health concern in Pakistan .']


Cluster  268
['A total of 23 patients with discogenic LBP were treated with single-level bipolar RFTC.', 'LFCN block reduced movement-related pain in patients with moderate-to-severe pain after THA.', 'A total of 108 LE patients whose pain was not relieved by 3 weeks of first-line treatment were included in a randomized manner, using an online application into DN or CS groups (54 patients each).', 'The efficacy of percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of discogenic low back pain (LBP) remains controversial.', 'Patients presenting with nonradicular, nonspecific LBP (minimum pain score 3 on 10-point visual analog scale) were recruited according to stringent inclusion criteria.', 'In the current study, both IA PRF stimulation and ICI into the LFJ significantly relieved LFJ pain.', 'Bipolar RFTC treatment can significantly attenuate pain and improve the function of patients with discogenic LBP.', 'Sixty patients with LFJ pain were recruited and randomly assigned to 1 of 2 groups: the IA PRF group and the ICI group.', 'We evaluated the effect of bipolar PRF on the DRG for the management of lumbosacral radicular pain.']


Cluster  878
['The aim of this study was to propose a new microprocessor-controlled prosthetic knee (MPK) and compare it with non-microprocessor-controlled prosthetic knees (NMPKs) under different walking speeds.', 'Intensity of effort during walking with Ankle Mimicking Prosthetic Foot is higher compared to current prostheses.', 'The results of this study indicated that the new microprocessor-controlled prosthetic knee was suitable for transfemoral amputees.', 'Shear stress at the stump in trans-tibial amputees induced by turning movements may be reduced with the use of torsion adapters in the prosthesis.', 'Compared to able-bodied individuals, the rating of perceived exertion levels were significantly elevated in transtibial and transfemoral amputees for both prostheses (p\u2009≤\u20090.']


Cluster  2021
['Maternal mortality from complications of unsafe abortion constitutes a serious problem in several developing countries .', 'In Brazil , the subject of induced abortion is controversial and considered by some to be a serious public health problem .', 'Abortion is a serious health problem in Brazil and complications can be avoided by adequate and timely care .', '[ Is abortion a serious public health problem in Chile in the field of maternal-perinatal health ? ]', 'Misuse of abortion pill by unauthorized persons is a serious concern in India .', 'Clandestine abortion is a serious public health problem in Brazil , and the inadequacy of family planning services is one of the causes of this problem .', 'Misoprostol is a pharmaceutical synthetic compound , analog of prostaglandin E1 , frequently used as an abortifacient in not medically supervised or self-induced abortions , particularly in countries with restrictive abortion laws representing a serious public health problem .', 'It is now more than 50 years since the World Health Assembly recognized abortion as a serious public health problem .', 'As evidenced by the high morbidity and mortality , abortions are a serious public health problem in rural Matebeleland North .', 'However , clandestine abortion remains a serious health problem in Bangladesh , and anecdotal reports indicate that clandestine use of misoprostol has increased since the most recent estimates ( for 2010 ) .']


Cluster  1931
['The prevalence of mental depression has increased in recent years , and has become a serious health problem in most countries of the world , including India .', 'This flows from a recognition of depression as a serious and costly problem , with women carrying twice the risk of men .', 'Depression is a serious health problem , with lifetime prevalence in the western world of 20 - 30 % .', 'Depression is a serious problem for women , one that is , in some cases , related to the sociocultural environment .', 'Depression poses a serious economic problem .', 'Depression is an extremely common mental health disorder, with prevalence rates rising.', 'The prevalence of depression worldwide is increasing from year to year and constitutes a serious medical , economic and social problem .', 'Depression is a life-threatening psychiatric disorder and a multifactorial global public health concern .', 'Major depression affects more than 5 % of the population and is a serious health and economic problem .', 'An increased incidence of depressive disorders observed in recent years in the Polish and world population is a serious health problem .', 'Globally, paternal depression is a neglected and under-researched area', 'Depression among nursing students is an ongoing problem.', 'Depression , a mental illness characterized by persistent feeling of sadness and loss of interest , has been a serious health problem worldwide .', 'Major depression is a serious public health problem and one of the most common psychiatric disorders , and it is estimated that millions of people are affected worldwide .', 'Major depression is a serious and often persistent problem for 5 to 10 percent of patients in primary care .', 'Depression is a common and impairing disorder which is a serious public health problem .', 'Major depression is a serious global health concern ; however , the pathophysiology underlying this condition remains unclear .', 'It can be assumed that depression is a serious mental health problem for university students because it affects all age groups of the students either younger or older equally .', 'Depression is a life-threatening psychiatric disorder and a major public health concern worldwide with an incidence of 5 % and a lifetime prevalence of 15%-20 % .']


Cluster  1741
['Neonatal RRS-StO2 measurements are feasible short term but do not correlate with ScvO2 and SpO2.', 'Retrograde blood flow in the ascending aorta was not associated with cerebral oxygenation, while diastolic backflow in the descending aorta was not associated with renal oxygenation in infants with LSOL.', 'Median crSO<sub>2</sub> increased from 43% (1 min after birth) to 49% (4 min after birth); thereafter, no significant changes were observed.', 'In healthy neonates, buccal RRS-StO2 values negatively correlated with the day of life.', 'We tested the hypothesis that during enteral feedings very low birth weight (VLBW) infants with a hematocrit ≤28% will experience a decrease in splanchnic rSO2 and splanchnic-cerebral oxygenation ratio (SCOR).', 'VLBW infants with a hematocrit ≤28% had a decrease in SCOR and a trend towards decreased splanchnic rSO2 with enteral feedings.']


Cluster  1594
['Obesity was found to be a serious health problem in the population of adolescents studied , especially given the high cardiovascular risk that is characteristic of this condition .', 'Becoming aware of the known link between PA and obesity led to positive behavior modification regarding PA in this cohort of Chinese students.', 'These findings advance the understanding of the utility and limitations of BMI in children and adolescents.', 'The prevalence of obesity , a serious public health problem , is increasing among teenagers and thus also increases cardiovascular morbidity and mortality in adulthood .', 'Unhealthy weight control behaviors are a serious concern , impairing the quality of life in adolescents .', 'The average value of BMI has increased over time ; overweight and obesity among adolescents has become a serious public health problem .', 'The prevalence of central obesity among children and adolescents has become a serious public health problem , which would arouse special attention .', 'Unhealthy eating behavior is a serious health concern among secondary school students in Inner Mongolia .', 'Eating disorders among the adolescent population are a serious health problem .', 'Prevalence of obesity among adolescents constitutes a serious public health problem .', 'The increasing prevalence of obesity in children and adolescents is a serious public health concern .', 'The average value of BMI has increased over time ; overweight and obesity among children and adolescents have become a serious public health problem .', 'Significant dropout rates remain a serious concern in pediatric weight control program , but few studies have identified predictors of dropout .', 'Adolescent obesity continues to be a serious concern around the world , placing young people at risk for chronic conditions and early death .', 'Obesity in children and adolescents is a severe health , psychosocial , and economic problem .', 'Extreme obesity among U.S. adolescents is a serious problem and has disproportionally affected ethnic minorities .', 'The average value of BMI and SFT has increased over time ; overweight and obesity among adolescents has become a serious public health problem .', 'The eating habits of adolescents are a serious current public health problem .', 'The prevalence of adolescent obesity has increased dramatically , becoming a serious public health concern .']


Cluster  2147
['Embolization of BAVM with Onyx<sup>®</sup> is an effective and safe method of treatment.', 'Alcohol septal ablation permanently eliminated the gradient in LVOT and improved the performance of patients, however it did not prevent a shift of HOCM to the dilated form.', 'Ninety patients admitted for LIVHR repair (defect size <15 cm) were randomized into 2 groups: nonabsorbable tacker fixation (NAT group, 45 patients) and absorbable tacker fixation (AT group, 45 patients).', 'The present retrospective cohort study included 407 Japanese patients who underwent needlescopic grasper-assisted and bendable retractor-assisted SILC between January 2012 and April 2017 at our institution.', 'Bilateral TEP repair resulted in higher VAS scores than unilateral repair at 2\xa0weeks but not 6\xa0weeks.', 'Bilateral UAE was successfully performed in all 100 patients, 88 of whom were clinically successfully treated, 45 (91.', 'Li quick repositioning maneuver for treatment of geotropic horizontal canal benign paroxysmal positional vertigo (HC-BPPV) was reported in the literature.', 'The Li maneuver is a rapid, simple and efficacious repositioning method for geotropic HC-BPPV and can be widely applied in clinical practice as an alternative method.']


Cluster  908
['Observational study.', 'We performed an observational study.', 'Observational study.', 'We conducted an observational study over 8 years.', 'Observational study.', 'This was an observational analysis of a quality improvement initiative.', 'We conducted an observational study between May 2011 and September 2012.']


Cluster  1381
['A potential problem with NAA tests is that some strains lack a target , which may be the one of main reasons for the much lower and highly variable accuracy in diagnosis .', 'A perceived drawback of DNA testing was that diabetes was considered not severe enough for this type of risk assessment .', 'Another problem associated with the HI test has been that it has often been difficult to obtain a second convalescent serum sample for an accurate diagnosis .', 'A sizeable proportion of testing for these analytes was inappropriate according to practice guidelines.', 'A clear limitation with this methodology is that laboratories do not examine smears from women with the same underlying risk , age distribution or screening interval and adjustment for these factors should considerably improve the method .', 'One lingering problem with these markers was that false positives occurred with Hürthle cell adenomas ( HCA ) which lowered test specificity .', 'The receipt of unsuitable samples is commonplace in laboratory practice and represents a serious problem , given the reliability of test results can be adversely compromised following analysis of these specimens .', 'For the nine analytes studied, the percentage of inappropriate tests ranged from 6% to 20%.', 'Therefore , a positive test result has a low predictive value [ 3.39 % ] and this is a serious drawback of the method .', 'A major drawback of the RDA analysis is the requirement for pure driver and relatively pure tester samples , ruling out the analysis of whole tissue biopsies .']


Cluster  707
['Contact dermatitis is a serious public health and dermatologic concern .', 'Allergic contact dermatitis is a serious health problem .', 'Occupational dermatoses represent a serious problem , especially the development of an allergy to constituents of the resin-based filling materials and adhesives .', 'Methylchloroisothiazolinone ( MCI ) and methylisothiazolinone ( MI ) contact dermatitis is a severe problem .', 'The standardized strip patch test method for the detection of allergic contact sensitization in patients with suspected allergic contact dermatitis is reliable.', 'Skin prick test (SPT) and specific IgE (sIgE) are approved for evaluation of allergen sensitization.', 'Patients with implant-related complications or a positive history of contact allergy and planned total joint replacements referred for allergological investigation between 2004 and 2017 were retrospectively analysed.', 'To examine the prevalence of wearing eye protection during dermatologic procedures by physicians, trainees, and office staff in dermatology.', 'A Cross-sectional observational study of US dermatologists, residents, nurses, and medical assistants was performed regarding eye protection during dermatologic procedures.']


Cluster  861
['The intention-to-treat analysis of all 450 patients revealed that the reported degree of pain during venipuncture depended to a large extent on the caliber of the chosen venous cannula.', 'This study aimed to identify risk factors for difficult intravenous cannulation in relation to characteristics of patients, healthcare providers and devices in adult patients accessing a radiology service.', 'Local anesthesia can be recommended before venipuncture only if a large cannula is used (e.g., ≥ 17G).', 'Trainee involvement resulted in longer cannulation times and increased use of precut sphincterotomy, but, was not associated with an increased risk of procedure related adverse events.', 'A randomized, controlled trial of fully factorial design was performed to study pain during venipuncture after local anesthesia either with intra - dermally injected lidocaine or with a vapocoolant spray, in comparison to placebo.']


Cluster  588
['Currently , Pb pollution has become a severe environmental problem and filamentous fungi hold a promising potential for the treatment of Pb-containing wastewater .', 'As one of the important contaminants in wastewater , Pb(II ) becomes a severe public health problem because of its non-biodegradable and persistent nature .', 'Boron ( B ) contamination of wastewater is a serious environmental and health problem , which has proved difficult to remediate .', 'The anthropogenic emission of boron to river has become a serious problem that deteriorates the water quality and endangers the ecosystem .']


Cluster  786
['Intractable nausea and/or vomiting is a serious and significant clinical dilemma that may greatly detract from quality of life .', 'Chronic unexplained nausea and vomiting is a debilitating condition that dramatically decreases patient quality of life and creates diagnostic and treatment challenges for healthcare providers .', 'Our trial found that ondansetron did not appear to be effective at preventing opioid-induced nausea or vomiting.', 'This study aimed to identify if prophylactic ondansetron administered with intravenous (IV) opioids prevents opioid-induced nausea or vomiting.', 'Chemotherapy-induced nausea and vomiting ( CINV ) continue to be a distressing problem still reported by cancer patients , with negative consequences on quality of life ( QoL ) .', 'Chemotherapy-induced nausea and vomiting ( CINV ) is a serious problem for cancer patients receiving chemotherapy .']


Cluster  122
['Older Korean 62 men and 270 women (mean age 73.', 'The prevalence among Greenlanders aged 20-79years was 2.', 'A higher prevalence of diagnosed diabetes was observed among non-Greenlanders compared to Greenlanders, while no major differences were observed in quality of care between the two groups.', 'We enrolled 40 female Korean volunteers who applied RAL 0.', 'A total of 26 Korean women seeking to lighten their skin were enrolled.', 'Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25']


Cluster  2350
['Change in 24-hour urine albumin excretion and plasma fibroblast growth factor 23 level.', 'ACR and PCR significantly underestimated 24-hour albumin and protein excretion (ACR Bias (IQR), -5.', 'Radiolabelled methods for measuring GFR are accurate but not practical and can be used only on a very limited scale while the traditional methods require timed urine collection with its drawback of inaccuracy , cumbersomeness and inconvenience for the patients .', 'The Walton-Bijvoet nomogram incorporates the assumption that GFR = creatinine clearance (Ccr).', 'In individuals aged ≥75 years, albuminuria and eGFR were associated with impairments in physical performance and self-reported functional status; however, only the association with albuminuria remained after adjusting for relevant demographics and comorbidities.', 'The primary problem with eGFR is that the non-GFR determinants of serum creatinine and cystatin C , as well as their surrogates ( age , sex , and race ) , associate with CKD risk factors and outcomes .', 'Plasma cystatin C (pCysC) may be superior to serum creatinine (sCr) as a surrogate of GFR.']


Cluster  74
['The differences between patients and controls in urine IL6 (F\u2009=\u200949.', 'In the morning of day 7, trough mean serum P4 concentrations were 169.', 'C-reactive protein >109 mg/ml (OR 3.', 'Prolactin (PRL) is a peptide hormone and several studies have demonstrated its role as a cytokine in human T cell-mediated immunity.', 'Blood and urine samples were collected, and classified into different groups according to several preanalytical variables: serum or plasma lithium-heparin tubes; spun or unspun; stored at room temperature (RT), at 4°C or frozen at -21°C.', 'The study population included 25 women and 12 men with mildly elevated serum prolactin levels (25-75\u2009ng/mL).', 'Plasma samples were collected from children who presented to an urban Emergency Department in North America.', 'About 54 serum samples from 27 patients were analyzed.']


Cluster  1282
['This study consisted of 168 patients who underwent percutaneous pedicle screw implantation between 2009 and 2016.', 'The purpose of this study was to investigate the effect of the FPA technique on the accuracy of pedicle screw placement, as well as on operating time, blood loss, and clinical outcomes.', 'If the pedicle screw passes though the cortex bone in surgery , it has a risk to damage the spinal cord and vertebral artery , which can be caused to a serious problem such as paralysis .', 'Macroscopic analysis showed a distinct drawback of posterior nail positioning , with diminished options for the placement of the locking screws and thereby a risk of damaging the anterior and posterior neuro-vascular bundles by distal medio-lateral locking screws .', 'To introduce a new entrance technique for C2 pedicle screw placement and to measure the related linear and angular parameters about the entrance point on computed tomography (CT) images.', 'The application of a drill guide template for pedicle screw placement is not more effective in reducing pain and disability after midterm follow-up in comparison with the free-hand technique.', 'A significant drawback of atlantoaxial transarticular screw fixation is a potential risk of vertebral artery injury , especially with a high-riding type .', "A serious problem arose in the form of migration of a meniscal screw that had been inserted in accordance with the manufacturer 's instructions .", 'Based on the data from our study, we conclude that there are no major differences between the sled devices and conventional screws relating to union rate and complications.']


Cluster  1252
['Both sedation regimens worsened the systolic function of both ventricles.', 'Our aim was to determine the incidence of complications from the administration of vasopressors through peripheral venous catheters (PVC) in patients with circulatory shock, and to identify the factors associated with these complications.', 'This may be regarded as a drawback of ACE inhibition when other factors interfere with cardiovascular homeostasis ; deleterious hemodynamic events may therefore occur when blood volume is decreased , which may be frequent during cardiovascular anesthesia and surgery .', 'The incidence of complications from the administration of vasopressors through a PVC is small and did not result in significant morbidity in this study.', 'A major drawback of the peripheral venoarterial extracorporeal membrane oxygenation is that in patients with profoundly reduced left ventricular contractility associated with high left-heart filling pressure , there is always concern for venting the failing ventricle .', 'Cardiopulmonary bypass induces a systematic inflammatory response, which is partly understood by investigation of peripheral blood cytokine levels alone; the lungs may interfere with the net cytokine concentration.', 'Bleeding remains a serious problem in patients with ventricular assist pumping ( VAP ) .', 'Heparin-induced IgE-mediated hypersensitivity and anaphylactoid reactions , although rare , can pose a serious clinical problem for patients requiring cardiopulmonary bypass ( CPB ) .', 'Overall cardiopulmonary adverse events were identified in 22 patients (34.']


Cluster  664
['A significant pain reduction at the end of the treatment in 51 (79.', 'Both therapies were effective in reducing pain throughout the follow up with greater improvement in DHT group at T1.', 'A significant reduction in pain and improvement in function was seen after 3\xa0months of therapy with additional improvement after 6\xa0months of therapy.', 'Both treatments had positive effect for improving pain, functional restoration and reduction in thickness of herniation.', 'When pain and the clinical and functional parameters were compared in both groups, significant improvement was found compared to baseline (p< 0.', 'At final follow-up, relief of leg pain was statistically significant for both groups.', 'The pain relieving effects of the combined treatment were very large (d= 1.', 'There was a significant difference between baseline and follow-up data: KOOS and COPM scores both improved; thigh muscle strength increased; and acute knee pain during full weight bearing walking diminished significantly.', 'Compared with group\xa0D, the incidence of pain and severe pain was lower in group\xa0A patients.', 'Although pain, disability, depression and quality of life improved similarly within all groups (all p\u2009<\u20090.', 'Pain and disability significantly decreased in both groups.', 'Intragroup analyses both treatments were effective in terms of sub parameters of pain, function and life quality (p< 0.', 'Posttreatment results showed significant improvements in all of the parameters (except SF - 36 pain parameter) in both groups.', 'A statistically significant improvement was highlighted in both groups in terms of pain score, and electromyography (EMG) analysis depicted a far superior functional recovery in the rPMS plus PKT group.', 'Post-treatment, a 50% reduction in median pain scores and an increase in mean quality of life were observed.', 'Majority of patients in both groups showed improvement in pain, neurological status, independent ambulation, and ECOG score in the postoperative period with no significant differences between the 2 groups.', 'According to the intragroup assessment, the study achieved its purpose of pain reduction, ROM increase, improvement of disability, quality of life, mood and reduction in drug use in all three treatment groups (P\u200a<\u200a0.']


Cluster  888
['In a two-way ANOVA with repeated measures, the aerobic gymnastic exercise group showed significant decrease in fatigue after practicing exercise 4 weeks and the positive effects extended to the 12-week posttests.', 'The present study demonstrated the greater fatigue resistance of men when performing 10RM BP and LP exercises.', 'The participants found high intensity exercise rehabilitation acceptable despite describing the exercise intensity as hard and reporting post-exercise fatigue.', 'Results indicated that an overloaded cycling protocol increased power output and lactate measures in anaerobic-trained men during a 30-second, Wingate Test.', 'Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity.', 'We compared metabolic, ventilatory and symptomatic responses during constant-load supported and unsupported exercise performed at 80° and 120° arm elevation.', 'Although no difference was observed between H1 and H3 values, neuromuscular fatigue parameters displayed different patterns over time.', "34 healthy subjects undertook three WOD (one per week): a G WOD consisting of completing the highest number of sets of 5 pull-ups, 10 push-ups and 15 air squats in 20 min; an M WOD, in which the maximum number of double skipping rope jumps was executed in 8 sets (20 s), resting (10 s) between sets; and finally, a W WOD in which the maximum number of power cleans was executed in 5 min, lifting a load equivalent to 40% of the individual's 1RM.", 'Time to exhaustion (Tlim), evaluated by Kaplan-Maier curve, was shorter at 120° than 80° arm elevation in both supported (360 vs.', 'Twenty anaerobic-trained men took part in this study.']


Cluster  753
['The same data sets as in the binary classification task were used . the inconsistency in human decisions ( Lin and Hovy , 2003 )', 'The representation of concepts in space contains an assignment of weights to the domains or dimensions , in order to distinguish between similar concepts -LRB- Gardenfors , 2004 -RRB- . a very small , and likely biased , subset of the policy sections is considered', 'The predetermined categories were empirically supported.', 'discrepancy between automatic and human evaluations -LRB- Callison-Burch et al. , 2007 -RRB- . they usually work with terms , and so disregard the contextual meaning of those terms in the sentence ( Martineau and Finin , 2009 ; Moilanen and Pulman , 2007 )', 'Such evaluation is complicated by cases where the distributions under comparison have different supports , i.e. 38 % of the slots that were identified are considered by the human judges to be too general', 'discrepancy between automatic and human evaluations -LRB- Callison-Burch et al. , 2007 -RRB- . they usually work with terms , and so disregard the contextual meaning of those terms in the sentence ( Martineau and Finin , 2009 ; Moilanen and Pulman , 2007 )', 'The main contribution of this paper is putting forward an approach which can make up for the limitation of using the statistical model or human knowledge purely by combining them organically', 'One shortcoming of this approach , for which the second evaluation seeks to compensate , is that a very small , and likely biased , subset of the policy sections is considered', 'A serious problem in stereology is to ensure a consistent definition of reference spaces at different levels of magnification whenever the boundaries of such reference spaces are either fuzzy or non-existent , and hence they have to be defined artificially .']


Cluster  926
['Intestinal failure-associated liver disease ( IFALD ) remains a serious problem in the treatment of infants with nutritional problems and short bowel syndrome .', 'Serum Intestinal Fatty-Acid Binding Protein (I-FABP) is a useful marker of bowel necrosis in pediatric intussusception.', 'We followed up a cohort of patients with prepouch ileitis that was originally described in 2009.', 'Malignant bowel obstruction ( MBO ) , a serious problem in stage IV colorectal cancer ( CRC ) patients , remains poorly understood .', 'Chronic intestinal pseudo-obstruction (CIPO) is an intractable rare digestive disease manifesting persistent small bowel distension without any mechanical cause.', 'The treatment of rectal cancer patients with large bowel obstruction ( LBO ) is a serious health care problem .', 'Bowel obstruction is a serious problem requiring prompt medical intervention to relieve intestinal distention , restore intravascular volume , and correct fluid and electrolyte balance .', 'All 31 patients had coexisting pouchitis at index diagnosis of prepouch ileitis.', 'We explored the balance between mucosal apoptotic enterocyte loss and cell regeneration in mild and advanced enteropathies.', 'Intestinal edema remains a serious clinical problem , and novel approaches to study its pathophysiology are needed .', 'Short gut syndrome is a devastating clinical problem with limited long-term treatment options .']


Cluster  1823
['Adverse events caused by flow-induced thrombus formation around the bearing/shaft of an axial blood pump remain a serious problem for axial blood pumps .', 'In developing centrifugal blood pumps , there has been a serious problem with hemolysis at the impeller or casing edge ; because of flow separation and turbulence in these regions .', 'Innovative design to prevent reversal of roller blood pump rotation in the event of electromechanical failure : an easy solution to a devastating problem .']


Cluster  153
['These three criteria are based on the output of an MT system , that is , how well the MT system can translate portions . the low coverage of the lexicon', 'The result is shown in Table 2 . PEM requires substantial in-domain bilingual data to train the semantic adequacy evaluator , as well as sample human judgments to train the overall metric', 'For example , in figure 2 , the first Chinese word MEP may be correspondent to the English chunk 5 or 7 . its predictions are not validated on actual documents', 'For the words with moderate training set frequencies , the precision is actually slightly higher for the systems built with just in-domain data , an effect that is more marked for the st domain . their dependency on seed examples or seed patterns which may lead to limited generalization due to dependency on handcrafted examples', 'Accuracy is used as an evaluation metric and is defined as the fraction of number of correctly identified SO words . there is no obvious way of showing how new schemas might be developed , or how existing ones might be modified', 'The same analyzer is used for deriving the meaning of questions and of texts from which the fact repository content is extracted . the generation of inconsistent sense clusters', 'is a binary preference value depending on the order of bilingual document pairs . crucial dependencies between ECs and other elements in the syntactic structure are not represented', 'Another issue with the linear representation of ECs is that crucial dependencies between ECs and other elements in the syntactic structure are not represented', 'These three criteria are based on the output of an MT system , that is , how well the MT system can translate portions . the low coverage of the lexicon', 'Table 7 shows the comparative results on the English test set and Table 8 reports the comparison on the Chinese test set . they use no or little grammatical knowledge , relying mainly on a target language model for producing correct target language texts , often resulting in ungrammatical output', 'To examine the similarity of the human judgments and that of the manual summaries , the kappa statistics , r. , was calculated using eq . LMF provides only a specification manual with a few examples', 'This contributes to its relatively higher precision since precision is a measure of the proportion of inferred boundaries that were correct . its dependence on semantic resources']


Cluster  18
['o-rMETase shows promise for treating patients with advanced prostate cancer.', 'Our study population consisted of 6537 prostate cancer cases from the Finnish Randomized Study of Screening for Prostate Cancer diagnosed during 1996-2009 (485 digoxin users).', 'The progression of prostate cancer during androgen deprivation therapy is a serious clinical problem .', 'No general protective effects against prostate cancer were observed for digoxin or sotalol usage.', 'In a randomized, double-blind, placebo-controlled trial, the utility of tacrolimus was assessed for prevention of erectile dysfunction following bilateral nerve-sparing radical prostatectomy.', 'Hormonal therapy is the mainstay of therapy , however castration-resistant prostate cancer ( CRPC ) becomes a serious problem and needs further clinical trials with novel agents .', 'In contrast to urinary continence , erectile dysfunction is still a serious concern for patients who undergo radical prostatectomy .', 'No association was found for prostate cancer death with digoxin usage before (HR 1.', 'Insensitivity of advanced-stage prostate cancer to androgen ablation therapy is a serious problem in clinical practice because it is associated with aggressive progression and poor prognosis .', 'Castration resistance is a serious problem facing clinical treatment of prostate cancer ( PCa ) .']


Cluster  427
['Although HPCs benefit patients , their delamination during use is a serious safety concern .', 'As this phenomenon poses a serious safety problem for medical personnel as well as for the product itself , an investigation was initiated to identify the root cause of the overpressure .', 'This temperature rise may present a serious biological problem , since it can cause iatrogenic thermal trauma to the pulp .', 'However , the formation of blood clots on the alloy surfaces is a serious concern .', 'Al3 + contamination may thus be a serious problem when using this apparatus .', 'For practical use , however , a fatal problem can occur when particulate components in the aqueous phase plug the holes .', 'Oxygen buildup would be a serious problem with any enclosed reactor , especially small-diameter tubes .']


Cluster  1073
['A significant percentage of Tyrolean adolescents showed difficulties in the development of competent media use, indicating the growing significance of prevention measures such as media education.', "Television viewing is negatively associated with children's school readiness skills, and this association increased as family income decreased.", 'Data derived from audiotapes of intervention classes, audits of computer exercises completed by participants, participant class attendance, and goal attainment scaling suggested relatively high fidelity to the intervention protocol.', 'Television viewing was negatively associated with math and EF but not with letter and word knowledge.', 'This study evaluates the effectiveness of a targeted multimedia educational intervention.']


Cluster  2367
['Environmental contamination with radioactive materials caused by the Fukushima Dai-ichi Nuclear Power Plant ( NPP ) accident in 2011 raised a serious health concern among residents in Japan , and the demand for radiation experts who can handle the radiation-associated problems has increased .', 'Radiocesium contamination of forests has been a severe problem after the Fukushima Daiichi Nuclear Power Plant accident in 2011 .', 'Uranium contamination in the environment is a serious public health concern .', 'Environmental contamination by uranium ( U ) and other radionuclides is a serious problem worldwide , especially due to , e.g. mining activities .', 'High concentrations of uranium(VI ) in the Witwatersrand Basin , South Africa from mining leachate is a serious environmental concern .', 'Radioactive materials in scrap metal are a serious problem for dealers and processors as well as for state radiation protection programs .', 'The accumulation of radionuclides can be a serious problem especially when this sludge is going to be reused , so more exhaustive information is required to prevent the possible radiological impact of these samples in the environment and also on the people .', 'Natural and artificial radionuclide pollutants of the marine environment have been recognized as a serious environmental concern .']


Cluster  902
['Based on this information inter-chunk dependencies are computed using a special purpose parser which is sensitive to the type of chunks . the individuals’ propensity of alignment is only characterized using a proportion of lexical elements', 'The probability , p -LRB- t | w -RRB- , of producing parse result t of a given sentence w is defined as the reliability of the rules is often language pair dependent', 'Based on this information inter-chunk dependencies are computed using a special purpose parser which is sensitive to the type of chunks . the individuals’ propensity of alignment is only characterized using a proportion of lexical elements', 'The probability , p -LRB- t | w -RRB- , of producing parse result t of a given sentence w is defined as the reliability of the rules is often language pair dependent', 'Based on this information inter-chunk dependencies are computed using a special purpose parser which is sensitive to the type of chunks . the individuals’ propensity of alignment is only characterized using a proportion of lexical elements']


Cluster  315
['However , pulmonary congestion can progress to a severe problem with ECLS therapy .', 'The main problem with the tumours present in the lungs is that they are non-stationary during each respiratory cycle .', 'Comparability of multiple breath washout (MBW) systems has been little explored.', 'The expiratory RP airway closure accompanied by expiratory flow limitation occurred more frequently in SDB patients (9/11, 82%) than in non-SDB subjects (2/9, 22%; exact logistic regression analysis: P=0.', 'Although significant advances have been made in ESCC diagnosis and therapy , its poor pathogenesis and prognosis remain a life-threatening problem .', 'Cyclical recruitment and derecruitment of lung parenchyma ( R/D ) remains a serious problem in ALI/ARDS patients , defined as atelectotrauma .', 'Pulmonary edema secondary to adenotonsillectomy is a serious surgical problem occurring in association with previous chronic , long-lasting obstructive complaints of the upper airway .', 'Comparison of the endOclear<sup>®</sup> group and controls demonstrated a trend toward a higher pneumonia rate in the former.', 'Valve-like dynamic RP closure that limits expiratory flow during nasal PPV occurs more frequently in SDB patients.', 'Recurrent airway obstruction ( RAO ) represents a serious health problem and is traditionally classified as an allergic disease , where contact with an antigen can induce clinical airway inflammation , bronchial hyper-responsiveness and reversible airway obstruction .', "A major drawback of BAI 's is the impaction in the upper airway .", 'The results suggested that chronic airway inflammation in ICS is not such a serious problem compared with DPB and BE .', 'Emergence of LRSA is a serious concern for CF patients who undergo prolonged courses of LZD therapy .', 'A major drawback of these models is represented by the transient nature of the airway pathology peaking 24 - 72 h after challenge and resolving in 1 - 2 weeks .', 'Inhaled glucocorticoids may increase the risk of pneumonia in adults.', 'However , if airway resistance in the nose is high , large adenoids would present a serious airway problem and cause predominantly mouth breathing .']


Cluster  481
["Asthma has a major impact on patients ' lives , and severe asthma is a serious health problem .", 'Exacerbations drive the burden of asthma and lead to significant morbidity and consumption of health care resources.', 'Asthma is a serious problem for low-income preteens living in disadvantaged communities .', 'Asthma is a serious health problem around the world , and affects approximately 10 - 15 % of children and 5 - 10 % of adults .', 'Fatal asthma is rare but constitutes a serious public health problem on account of the raised prevalence of the disease .', 'Asthma in Puerto Rico is a serious Public Health Problem .', 'Recognizing the significance of asthma as a serious public health problem , Healthy People 2000 has targeted improvements in asthma care as one of its objectives and the National Heart , Lung , and Blood Institute has research and education programs to improve the health of our children with asthma .', 'Asthmatic death in the elderly is a serious problem worldwide .', 'Asthma is a serious global health problem .', 'Asthma is a chronic immune disease that has become a serious public health problem .', 'Asthma is a serious global health problem that has steadily increased in prevalence during the past two decades .', 'Asthma is a multifactorial disease and a serious public health problem .', 'We focus here on childhood asthma as an example of a serious public health problem that has been associated with low income , minority status , and characteristics of the home environment .', 'Asthma is a serious global health problem , severely affecting the lives of sufferers and their families .', 'Asthma , a chronic inflammatory condition defined by episodic shortness of breath with expiratory wheezing and cough , is a serious health concern affecting more than 250 million persons .', 'Asthma remains a troubling health problem despite the availability of effective treatment .', 'The microcosting of management of asthma-related events provides more accurate estimates that could be used in local economic studies.', 'Asthma is a serious health problem causing significant mortality and morbidity globally .', 'Asthma , a serious health problem worldwide , is becoming more common .', 'Asthma is a chronic airway disease that is based on an inflammatory process and a serious health problem around the world .', 'Asthma is a chronic inflammatory disorder requiring intermittent or continuous anti-inflammatory therapy.', 'Asthma is a serious world health problem characterised by a chronic inflammatory disorder of the airways .', 'Asthma is a serious global health problem that affects people of all ages .', 'Asthma is a serious public health concern , disproportionately affecting urban , minority populations .', 'Asthma is a serious health problem , with both mortality and severity increasing in developed countries ( 55 - 57 ) .']


Cluster  1278
['Motion during MRI examinations is a serious problem that degrades the quality of the data ( images ) acquired .', 'A drawback of MR-guided interventions is the limitation in verbal communication during image acquisition .', 'Unpleasant acoustic noise is a drawback of almost every MRI scan .', 'Artifacts caused by patient motion during scanning remain a serious problem in most MRI applications .', 'We evaluated an introductory instruction program as an assistive tool in performing MRI without anesthesia.', 'The problem with these methods is that they need to deal with intensity bias correction and other MRI-specific noise .']


Cluster  1953
['Acute kidney injury remains a serious clinical problem for intensive care unit patients , and its incidence is rising .', 'Acute kidney injury ( AKI ) is a serious problem in critically ill patients of intensive care units .', 'The incidence of AKI as per Acute Kidney Injury Network (AKIN) criteria was comparable in cooling and non-cooling groups (40% versus 53%, respectively).', 'Acute kidney injury ( AKI ) is a serious problem .', 'Acute kidney injury ( AKI ) is a devastating clinical problem that affects a growing number of patients , especially elderly ones , and is associated with high morbidity and mortality .', 'Acute kidney injury ( AKI ) is a serious clinical problem with high rate of mortality and morbidity .', 'Acute kidney injury ( AKI ) is a serious clinical problem with high morbidity and mortality .', 'Acute kidney injury ( AKI ) is a serious global public health problem .', 'Acute kidney injury ( AKI ) is a serious and common problem that is associated with high mortality .', 'Acute kidney injury ( AKI ) remains a serious clinical problem in the intensive care unit ( ICU ) .']


Cluster  845
['Osteoporosis is a serious health problem of endemic proportions in the United States .', 'It is essential to evaluate osteoporosis risk factors , mainly the modifiable , like the lifestyle , in Mexican women in order to prevent it , since it is a serious public health problem .', 'Osteoporosis is a serious health problem among postmenopausal women .', 'Osteoporosis is a serious clinical problem that often follows the accelerated bone loss that occurs after the estrogen withdrawal of menopause .', 'Osteoporosis represents a serious health problem worldwide associated with an increased risk of fractures and mortality .', 'Estrogen deficiency osteoporosis has become a serious problem in elderly women .', 'Osteoporosis is a serious global health problem for the future , that is why improving diagnostic methods and prevention of this disease could be helpful .', 'Osteoporosis is a serious national and global public health problem , but data on bone health are limited for Asian women living in the U.S. , the majority of whom are Chinese .', 'Osteoporosis ( OP ) is a serious health problem that contributes to osteoporotic structural damage and bone fragility .', 'Osteoporosis is a serious problem , since about 50 % of women over the age of 50 suffer at least one osteoporotic fracture .', 'Osteoporosis is a serious health problem worldwide .', 'Osteoporosis is a serious health problem in both Caucasians and Asians .', 'Osteoporosis is a serious national public health problem , and is expected to increase significantly over the next few decades , especially in women .', 'Recently , the incidence of osteoporosis and its related fracture are increasing as the aging of population has been progressing in most developed countries , becoming a serious medical and social problem .', 'Osteoporosis constitutes a serious health problem in old people .', 'Aging-related osteoporosis ( OP ) is considered a serious public health concern .', 'Osteoporotic fractures are a debilitating and a frequently fatal health problem for older adults .', 'Osteoporosis is a serious problem worldwide ; it is characterized by bone fractures in response to relatively mild trauma .', 'Osteoporosis is a serious public health concern .', 'Osteoporosis represents a serious health problem worldwide and is associated with an increased risk for fractures and mortality .', 'Osteoporosis has rapidly evolved into a severe health threat to Americans and a major public health problem .', 'Hip fracture constitutes a serious healthcare problem in Chile , and efforts for the prevention and management of osteoporosis are needed .', 'The high worldwide prevalence of osteoporosis means it is considered a serious public health concern , possibly leading to physical disability and an increased mortality rate .', 'The most serious complication of osteoporosis is bone fractures , especially fractures of the proximal femur , which are a serious medical and social problem .', 'Osteoporosis is a serious health problem that has reached epidemic proportions among Canadian women .', 'For long-term treatment , the development of osteoporosis is a serious problem .', 'Because of its high prevalence worldwide , osteoporosis is considered a serious public health concern .', 'Osteoporosis is a serious public health problem , and dietary interventions may potentially be helpful in preventing this disorder .', 'Osteoporosis is a skeletal disease mainly affecting women over 50 years old and it represents a serious public health problem because of the high socioeconomic burden .', 'Postmenopausal osteoporosis is a serious health problem , and additional treatments are needed .', 'Osteoporosis is a serious medical problem because of its complications , most frequently manifesting itself in spine fractures , fractures of distal sections of the forearm and , in later periods of life , hip fractures .', 'Osteoporosis in the elderly is a serious problem that is increasing as the population ages .', '" Osteoporosis and the consequences of compromised bone strength -- particularly vertebral and hip fractures -- are a significant cause of frailty , and increased morbidity and even mortality and hence are a serious and costly public health problem in the elderly population .', 'Osteoporosis is a serious health problem that diminishes quality of life and levies a financial burden on those who fear and experience bone fractures .', 'Osteoporosis is a serious health concern affecting millions of Americans , with many patients going undiagnosed and untreated .', 'Osteoporosis is a serious health problem worldwide .', 'Diabetic osteoporosis is a severe public health concern in the world .', 'Osteoporosis is a serious public health concern worldwide , and community-based public health programs that increase osteoporosis preventive behaviors are ideal to combat this major public health issue .', 'Osteoporosis had become a serious public health problem among the elderly , bringing about the increase of economic burden all over the world both on social healthcare and families of the patients .', 'Osteoporosis is a serious public health problem , leading to significant mortality not only in aging females but also in males .', "By the impact of demographic changes and as the result of the ' incorrect ' lifestyles pursued in developed societies , osteoporosis has become a serious social problem .", 'Osteoporosis , the most common metabolic bone disease , is a devastating problem and an increasingly major public health issue .', "Osteoporosis and pathological bone fractures which are its consequences are a serious health problem of today 's world .", 'Osteoporosis is a serious worldwide public health concern .', 'Osteoporosis is a serious health problem that worsens the quality of life and the survival rate of individuals with this disease on account the osteoporotic fractures .']


Cluster  2205
['There was a lower statistical significant syncope recurrence at follow-up, comparing group A to group B of patients [n of events 9 (40.', 'In this study, we enrolled 72 consecutive patients affected by syncope with cardioinhibitory response without asystolic significant pause to HUT (2A type).', 'The incidence of short-term true outcomes of syncope is extremely low.']


Cluster  934
['The awareness of the importance of sequential monitoring of pigmented lesions, with particular attention to the lesions of new onset, is crucial for the best management of these complex patients.', 'To evaluate the efficacy and safety of a new brightening complex cream containing niacinamide, tranexamic acid, oxyresveratrol, glutathione disulfide, and linoleic acid.', 'Fluorescence quantity indicates acne severity, especially on the inner cheek and chin areas.', 'Prior to the start of the protocol, the mean difference between pigmented and normal skin was calculated for cysteamine and placebo groups using both Dermacatch<sup>®</sup> (72.', 'To determine the efficacy of cysteamine cream in the treatment of patients with epidermal melasma using Dermacatch<sup>®</sup> as a more accurate skin colorimetric measurement tool.', 'Clinical evaluation and photometric measurement revealed the reduction of redness in the treated side compared with untreated side and baseline.', "To compare safety and efficacy of combined trichloroacetic acid (TCA) (20%-25%) and Jessner's solution versus TCA (20%-25%) alone in dark patients with melasma.", 'Participating patients (n\u2009=\u200940) received either placebo (n\u2009=\u200920) or cysteamine cream (n\u2009=\u200920) in a double-blind placebo controlled study.', 'Both color measurement methods, chromametry and color-calibrated camera, showed that lentigines treated over time with the SPF30 day skin cream were significantly lighter than the non-treated lentigines.', 'EASI showed excellent reliability for patients of all skin colours, and is recommended as the optimal core measure for patients with all skin colours.']


Cluster  1409
['Common treatment-related toxicities included diarrhea, fatigue, and mucositis.', 'In Chinese subjects, alirocumab 75, 150, and 300\xa0mg was safe and well-tolerated.', 'Our objectives were to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of single ascending doses of alirocumab in healthy Chinese subjects.', 'There were no immediate hypersensitivity reactions (e.g. wheals, vomiting).', 'Treatment-emergent adverse events, most frequently nasal congestion and dry throat, were reported in three of seven or eight subjects in each alirocumab dose group (two of seven in the placebo group).']


Cluster  2361
['A total of 50 patients who met the inclusion criteria had a body mass index ranging from 28.', 'In the obese cohort, 55.', 'Mean patient age was 44 years, and mean body mass index (BMI) was 23.', 'Current median body mass indexes for the obese and control subjects were 37.', 'Mean age was 47·6 ± 11·4 years and mean body mass index 34·6 ± 3·9 kg/m<sup>2</sup> .']


Cluster  2238
['Reproductive-stage drought stress is a major impediment to rice production in rainfed areas', 'Grain filling rates (GFRs) of indica rice cultivars are often higher than those of japonica cultivars', 'The frequent occurrence of chalky rice ( Oryza sativa L. ) grains becomes a serious problem as a result of climate change .', 'Reduction in rice yield caused by high temperature-induced spikelet sterility has been a serious concern in rice production .', 'The effect can be a serious problem for rice farmers in the rainfed lowlands of Asia , and runs contrary to a widespread belief amongst plant biologists that rice is highly tolerant of submergence .', 'Flooding of rice fields is a serious problem in the river basins of South and South-East Asia where about 15 Mha of lowland rice cultivation is regularly affected .']


Cluster  1860
['Before transplantation, a significant difference between sGFR and bGFR (p = 0.', 'The study included 214 patients: 65 had surgery, 73 had EVLA and 76 had UGFS.', 'Our results indicate that urine [TIMP-2]·[IGFBP7] immediately after transplantation could be an early, predictive biomarker of DGF in kidney transplantation.', 'Twenty-three patients (31%) were diagnosed with DGF.']


Cluster  2001
['The numbers for the normal-form model are evaluated by running the publicly available parser , while those for the hybrid dependency model are from Clark and Curran -LRB- 2007 -RRB- . underrepresentation of Kazakh language in various fields such as science , entertainment , official documentation , etc .', 'This fact in turn caused the problem of underrepresentation of Kazakh language in various fields such as science , entertainment , official documentation , etc .', 'Experiments with young children support these predictions . not all of the interviewees could read in Kazakh sufficiently fluent']


Cluster  703
['Use of the new PedC diagnostic criteria for PCOM results in a lower prevalence of this ultrasonographic pattern in adolescents, but this condition is not associated with hyperandrogenism.', 'Polycystic ovarian syndrome ( PCOS ) is a serious health problem that affects women of all ages worldwide , including their quality of life ( QOL ) .', 'Polycystic ovary syndrome (PCOS) is common endocrine disorder in women and can lead to serious social burdens associated with various reproductive and metabolic abnormalities', 'The ultrasonographic criteria used to identify polycystic ovarian morphology (PCOM) during adolescence have changed over time.', 'Seventy-four PCOS subjects (aged 16 years) and 82 controls (aged 16 years) were evaluated by an oral glucose tolerance test.', 'Abnormal glucose dynamics in adolescents with PCOS is mainly due to SO.', 'Increased levels of both sTWEAK and PCOS were found to be independently associated with dyslipidemia in youth.']


Cluster  561
['Event extraction has been studied mainly in the newswire domain and the biomedical domain as the task of detecting event triggers and determining their event types and arguments . it finds only a local optimum , since it uses the same backpropagation technique as MLP', 'In this article , we present the first broad-coverage probabilistic parser for PLTAG , a variant of TAG that supports all three requirements . the softmax normalization would be very costly for large vocabularies', 'This approach has however never been applied to large scale term extraction because it is based on a full semantic analysis of sentences . the complexity in syntactic processing is coupled with semantic parsing and makes the latter even harder', 'FNTBL is a transformation-based learner that is distributed with pre-optimised POS tagging modules for English and other European languages that can be redeployed over the task of supertagging . the number of labels grows unbounded with the treebank size , as we may encounter complex substructures where the event sequences are long', 'One weakness of this rulebased tagger is that no unsupervised training algorithm has been presented for learning rules automatically without a manually annotated corpus', 'The queries used for system development and threshold tuning were created by the authors , while queries based on the set of event types in the ACE extraction evaluations were used for testing . the actual lexical information gets lost in favor of marking IGs , preventing the potential usage of that information in deciding on inter-word dependencies', 'Traditionally , a text parser outputs a complete parse tree for each input sentence , achieving a speed in the order of 10 words per second -LRB- wps -RRB- -LRB- Abney 1997 -RRB- . no unsupervised training algorithm has been presented for learning rules automatically without a manually annotated corpus', 'One problem that arises by using full syntactic labels is that they require an exact match of the constituents in extracted phrases , so it faces the risk of losing coverage of the rules']


Cluster  1301
['Lymph node metastasis and DSI are risk factors for late recurrence.', 'The long-term findings presented in this report expand on and confirm previously published results demonstrating decreased morbidity and oncologic noninferiority of VIL, further validating the technique for patients requiring lymphadenectomy.', 'Patients aged 41 to 73 years with resectable NSCLC were randomly assigned via a computer-generated randomisation sequence to receive either uniportal VATS (UVATS) or multiportal VATS (MVATS) lobectomy and lymphadenectomy between December 2015 and October 2016.', 'Lymph node metastasis of lung cancer is a serious problem .', 'Clinically , treatment of distant metastases is a serious problem in EBV-associated non-keratinizing NPC , because frequently there is lymph node involvement and distant metastasis before detection of the primary tumor .', 'Undertreatment , especially of the lymph nodes in the neck , is a serious problem as regional (micro)metastasis are common even in T1 tumors .', 'Recurrent vulvar lymphangitis secondary to pelvic lymphadenectomy and radiation therapy can be a vexing clinical dilemma .']


Cluster  241
['In our setting, mercaptopurine is primarily used as a rescue therapy in patients with azathioprine adverse effects.', 'Regorafenib improves survival in chemorefractory metastatic colorectal cancer (mCRC) patients.', 'Multiple relapses in patients taking primaquine as prescribed present a serious clinical problem , and understanding the basis of repeated therapeutic failure is a challenging technical problem .', 'Fluoroquinolones are an integral part of recommended MDR-TB regimens.', 'We retrospectively examined 146 consecutive mCRC patients who received regorafenib.', 'Continuous surveillance and monitoring are needed because the widespread of tigecycline- and fluoroquinolone-coresistant MBL producers may become a serious therapeutic problem .', 'Retrospective observational study in patients treated with mercaptopurine in a total cohort of 1,574 patients with inflammatory bowel disease.']


Cluster  1992
['Pollution of the environment with heavy metals is a serious problem , which is recognized in most countries of the world .', 'Heavy metal pollution is a severe problem worldwide .', 'Heavy metal pollution is a serious environmental problem in the world , especially in developing countries .', 'Environmental pollution by heavy metals has become a serious problem in the world .', 'Heavy metal contamination in lake sediments is a serious problem , particularly in developing countries such as China .', 'Heavy metals contamination is a serious problem of China .', 'There has been a significant rise in the levels of heavy metals ( Pb , As , Hg and Cd ) due to their increased industrial usage causing a severe concern to public health .', 'Increasing concentration of heavy metals ( HM ) due to various anthropogenic activities is a serious problem .', 'Heavy metal pollution is a serious problem worldwide .', 'Metal ion contamination of drinking water and waste water is a serious ongoing problem especially with high toxic metals such as lead and cadmium and less toxic metals such as copper and zinc .', 'Contamination by heavy metals and metalloids is a serious environmental and health concern .', 'Heavy metal pollution is a serious problem for', 'The pollution of environmental systems with heavy metals is becoming a serious problem worldwide .', 'Heavy metal contamination in wastewater is a serious problem due to its high toxicity .', 'But , elevating levels of heavy metals in water and fish made a serious concern about ecosystem and food chain contamination .', 'Water contamination by heavy metals from industrial activities is a serious environmental concern .', 'A serious problem with this is the severe soil contamination that resulted from intensive mining and metallurgical activities that has taken place in the greater area for the past 3,000 years .', 'Water pollution of heavy metals such as cadmium is a serious problem in China .', 'In recent years , talks on toxic metal pollution had taken center stage in most scientific symposiums as a serious health concern .', 'Remediation of these systems turns into a serious problem due to various anthropogenic activities that have significantly raised the amount of heavy metals and radionuclides in it .', 'Heavy metal ion pollution is a severe problem in environmental protection and especially in human health due to their bioaccumulation in organisms .', 'The Ulansuhai River is polluted by heavy metals and faces a serious problem of eutrophication .']


Cluster  147
['Nivolumab treatment outside clinical trials seems to perform as expected.', 'Up to 48 patients with polymetastatic cancer (>\u200910 sites) will be enrolled on this phase I, modified 3\u2009+\u20093 design trial.', 'A key task for the pharmaceutical industry is to understand the compliance implications of engaging with a patient advocacy group (PAG)', 'Recruitment of skilled nursing facilities and patients in skilled nursing facilities for clinical trials is challenging.', 'The underreporting of final results of Phase I oncology trials remains a serious problem .', 'This trend may become a serious problem for non-profit promoters of cancer clinical trials .', 'This study was a prospective randomized controlled trial, which was conducted at a cancer referral center.', 'The phase III NARLAL2 trial randomizes patients between a standard and an escalated treatment plan.', 'This article describes the process from the planning to the rejection of a\xa0clinical trial over the period from 2009 to 2015.', 'Patients who learned that they had been randomized to bevacizumab perceived higher risk of having a serious problem caused by treatment ( P \u2009 = \u2009 .01 ) .', 'Insufficient patient enrollment in clinical trials remains a serious and costly problem and is often considered the most critical issue to solve for the clinical trials community .']


Cluster  1395
['To analyse pain and functional capacity in women with pelvic girdle pain and to evaluate the effect of pelvic belt on these parameters.', 'High energy pelvic ring disruption represents a serious clinical problem with an overall reported mortality rate of approximately 10 % ( 1 ) .', 'Patients with combined pelvic and acetabular fractures represent a serious injury that includes the resuscitative challenges of pelvic injuries coupled with the difficulties of precise reduction of acetabular fractures .', 'Pelvis ring fractures of geriatric patients are currently a serious problem in orthopedic and trauma surgery .', 'PURPOSE OF THE STUDY Fragility fractures of the pelvic ring in the elderly population are a serious problem in orthopaedics .', 'Testing of mechanical stability of the pelvic ring was carried out less often and with lower consequences for the actual management than expected.']


Cluster  252
['Data from 201 gastric cancer patients at Fujian Medical University Union Hospital who were enrolled in our prospective randomized controlled trial were extracted for this study.', 'An observational prospective cohort study for gastric cancer has been conducted since 2010.', 'Gastric cancer ( GC ) represents a serious health problem on a global scale .', 'Gastric cancer is a serious health problem worldwide , with particularly high prevalence in eastern Asia .', 'Gastric cancer ( GC ) is a severe public health problem worldwide , particularly in China .', 'Gastric cancer is a serious public health problem in Northern Brazil and in the world due to its high incidence and mortality .', 'Gastric cancer is a serious problem for human health .', 'Gastric cancer ( GC ) is one of the leading causes of cancer-related deaths worldwide , and its high mortality rate is a serious problem in many regions .', 'We retrospectively collected data of gastric and gastro-esophageal cancer patients treated from January 2015 till December 2016.', 'Although peritoneal metastasis is a serious concern in patients with gastric cancer , no acceptable and specific biomarker is available .', 'Although the overall incidence of gastric cancer has been declining in the United States , the disease continues to be a devastating problem worldwide .', 'Recently , the number of aged patients with gastric cancer have increased remarkably , indicating a serious diagnostic problem in the near future .', 'Peritoneal recurrence of gastric cancer patients is a serious problem .', 'Gastric and colonic cancer , which affect alarmingly also younger age groups to a growing extent , are developing into a serious problem of public health .', 'In resectable gastric cancer, the incidence of metastases in the greater omentum is low, and when present associated with advanced disease and non-radical features.', 'One hundred sixty-six patients with gastric adenoma or early gastric cancer were enrolled.']


Cluster  829
['We retrospectively identified surgically treated metastatic EC patients from our esophagectomy database.', 'Postoperative sarcopenia following esophagectomy for esophageal cancer has become a severe problem due to the increasing number of elderly patients undergoing surgery .', 'The modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI), and Prognostic Nutrition Index (PNI) were calculated for 723 consecutive patients undergoing oesophagectomy or gastrectomy at a single center.', 'Patients scheduled for esophagus resection according to Ivor-Lewis were randomized to an intervention group or a control group.', 'Out of 443 patients undergoing minimally invasive esophagectomy, 18 (4.', 'Perioperative psychological support reduces impairment in quality of life and quality of sleep after oesophagectomy.', 'To evaluate the safety and efficacy of an indigenous fully-covered SEMS in patients with esophageal cancer.', 'The implementation of GDT during esophagectomy was not associated with reductions in overall morbidity, mortality and hospital length of stay.', 'The inflammatory complications still remain a serious problem after oesophagectomy with a great portion on postoperative mortality .', 'TEA does not affect the AL risk after esophagectomy.', 'Our retrospective study identified patients who underwent elective esophagectomy between July 2013 and July 2016.', 'Observational cohort design study with convenience retrospective data in both genders, over 18 years, undergoing to total gastrectomy and/or elective esophagectomy.', 'Mesenteric traction syndrome manifests more frequently during open than robotically assisted esophagectomy, and postoperative complications appear to be associated with severe mesenteric traction syndrome.', 'This single-centre study enrolled patients scheduled for transthoracic oesophagectomy in a randomized, double-blind, placebo-controlled trial between March 2013 and January 2016.', 'Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients.', 'Forty-five patients undergoing open esophagectomy were randomized to primary activation (EA; 25 patients) or no intraoperative activation (LA; 20 patients) of TEA.']


Cluster  759
['The rate of new cases of multidrug resistant tuberculosis ( MDRTB ) continues to increase , and since these infections are very difficult to manage , they constitute a serious health problem .', 'Multidrug-resistant-TB and extensively resistant-TB are a serious problem for control programs .', 'Multi-drug resistant tuberculosis is a serious clinical problem .', 'Multidrug-resistant tuberculosis ( MDR-TB , defined as resistance to at least both rifampicin and isoniazid ) has become a serious problem in the United Kingdom .', 'Tuberculosis ( TB ) remains a serious public health problem aggravated by the emergence of M. tuberculosis ( Mtb ) strains resistant to multiple drugs ( MDR ) .', 'Extensively drug-resistant tuberculosis ( XDR-TB ) is a serious worldwide problem .', 'Drug-resistant tuberculosis ( TB ) is a serious global problem , and pathogen factors involved in the transmission of isoniazid (INH)-resistant TB have not been fully investigated .', 'Tuberculosis ( TB ) remains one of the leading causes of morbidity and mortality all over the world and multidrug resistance TB ( MDR-TB ) pose a serious threat to the TB control and represent an increasing public health problem .', 'XDR-TB has become a serious problem for the health administrations in this region .', 'The emergence of drug resistant tuberculosis poses a serious concern globally and researchers are in rigorous search for new drugs to fight against these dreadful bacteria .', 'The high rates of resistance to ethionamide , capreomycin , and kanamycin show the real burden of drug resistance in the region and pose a serious problem for the treatment of patients with multidrug-resistant tuberculosis .', 'Multidrug-resistant tuberculosis ( MDRTB ) is a serious world health problem that limits public actions to control tuberculosis , because the most used anti-tuberculosis first-line drugs fail to stop mycobacterium spread .', 'Drug resistant tuberculosis ( TB ) has lately emerged and it represents a serious public health problem .', 'Resistance and tolerance to antituberculosis ( anti-TB ) drugs , especially the first-line drugs , has become a serious problem in anti-TB therapy .', 'Resistance to anti-tuberculosis drugs is a serious public health problem .', 'The results of this analysis of drug resistance in MTB reflect the situation in a local hospital and indicate that the morbidity related to TB , especially MDR-TB , is still a serious health problem .', 'Resurgence of strains of multiple-drug resistant tuberculosis is a serious concern .', 'The results show that drug resistance is indeed a serious problem and it may compliment the efforts of the National Tuberculosis Programme to improve strategies to control this disease .', 'Multidrug tuberculosis ( MDR-TB ) and extensively drug-resistant tuberculosis ( XDR-TB ) cases constitute a serious health problem in Portugal , of which the majority of isolates belong to the Lisboa family and the Q1 cluster , highly related to the Lisboa family .', 'MDR and XDR tuberculosis are associated with high morbidity and substantial mortality , are a threat to health-care workers , prohibitively expensive to treat , and are therefore a serious public health problem .', 'Tuberculosis remains a serious health problem throughout the world , and new drugs are needed to help control this disease .', 'Multidrug-resistant ( MDR ) tuberculosis , defined as tuberculosis resistant to the two first-line drugs isoniazid and rifampin , poses a serious problem for global tuberculosis control strategies .', 'Drug resistant tuberculosis is a serious problem in control of tuberculosis .', 'The lengthy TB chemotherapeutic regimen , resulting in the emergence of drug resistance strains , poses a serious problem in the cure of the disease .', 'Sub-standard deteriorated TB drugs are a serious problem for TB control .', 'Multidrug-resistant tuberculosis ( MDR-TB , defined as resistance to at least isoniazid and rifampicin ) has emerged as a serious global public health problem , especially in the former Soviet republics .', 'Extensively drug-resistant ( XDR ) tuberculosis ( TB ) represents a serious and growing problem in both endemic and non-endemic countries .', 'Drug resistant tuberculosis y a serious problem in Chiapas that requires urgent attention if future control of the disease is to be maintained .', 'Drug-resistant tuberculosis ( DR-TB ) is a serious problem that impedes the success of the TB control program .', 'Tuberculosis ( TB ) is a serious worldwide public health problem , and drug resistance , particularly multidrug resistance ( MDR ) , is a critical factor involved in TB control .', 'In the past decade , the incidence of tuberculosis has been decreased in Korea and the nationwide survey of tuberculosis from 1965 through 1990 suggested a declining tendency of resistant organisms . But the prevalence rate of multidrug resistance of Mycobacterium tuberculosis is still a serious problem in Korea , and the aim of this study is to check the drug resistance pattern in the patients visiting University Hospital , the 3rd referral center .', 'Drug-resistant tuberculosis is a serious problem throughout the world .']


Cluster  1164
['The purpose of this study was to assess the effectiveness of pulsed high-intensity laser therapy on pain, adhesions, and quality of life in women with endometriosis.', 'Pulsed high-intensity laser therapy is an effective method of pain alleviation, reducing adhesions, and improving the quality of life in women with endometriosis.', 'The study aimed to assess pelvic pain and quality of life before and after laparoscopic bowel resection for rectosigmoid endometriosis.', 'Significant differences were detected between the control and stage III-IV endometriosis groups and between stage I-II and stage III-IV endometriosis groups in terms of caspase-3 levels (both, p < 0.', 'The sample included 40 women with endometriosis to either a mild or a moderate degree aged between 24 and 32 years.']


Cluster  106
['Forty-one patients underwent 82 ECT sessions.', 'This study examined unpublished EMA data from a subset of participants (N=55) in a previously published RCT (NCT01505101) of MORE versus a support group (SG) control.', 'The prevalence of EIPH based on TBE EIPH score was 54%.', 'Traditional cardiac risk factors have limited association with AMI in the ED, but an increasing risk factor burden is associated with increasing prevalence of AMI.', 'The post-test probability of AMI in the absence of risk factors (9.', '46/161 patients had a relapse in the first year and 44/161 had EDSS progression by year 2.', 'The data was from a multicenter prospective study including patients presenting to the emergency department with symptoms of AMI.', 'The values of CO, SV, and EF in the patients of SM group at t3 to t6 were found to be significantly higher than those at t1 (P\u200a<\u200a.', 'ET in addition to CT was more effective and safe treatment in VI.', 'Following the implementation of the NST, fewer EAs were seen in PN patients (53%; χ<sup>2</sup> \xa0=\xa010.', 'Another problem with CREATE-ECLA is that the mortality in Killip class 1 reperfused patients was 7.1 % , much higher than that of a recent Dutch study in which mortality was only 1.2 % .', 'There were 123 patients (age 63 ± 11 years, systolic blood pressure 135 ± 18 mm Hg, eGFR 32 ± 16 mL/min/1.', 'We identified 18,664 eligible patients from 6 different EDs during the study period (2012-2016).', 'In a prospective observational study, 654 consecutive patients diagnosed with AMI underwent ankle brachial index (ABI) measurements and ultrasonographic screening of the carotid arteries and abdominal aorta.', 'Sixteen German ET patients participated in this study.', 'This postdischarge intervention was associated with only small and nonsignificant reductions in ED reattendance.', 'High relapse rates after ECT remain a serious and common clinical dilemma .', 'It was a prospective observational study that included 32 patients of type "C" EA between January 2014 and December 2016.', 'The overall incidence of EA was lower in the nefopam group than in the control group (34% [17/50] vs 54% [27/50], respectively; P\u200a=\u200a.', 'Two hundred patients previously treated with ERFA were recalled for clinical assessment and venous-duplex ultrasound at three years post-treatment.', 'The use of ERIC as a first device appeared to be associated with higher rates of successful recanalization and resulted in better functional outcome.', 'Despite receiving similar evidence-based medication at discharge, patients with clinical ECAD, but not patients with a subclinical ECAD, had worse long-term prognosis than patients without an ECAD after AMI.', 'After exclusion of 3 patients, 55 were in the EGEWF group and 56 in the ERCP group.', 'Prevalence of ER pattern was 23,6% (95% CI 21-26.', 'Cross-sectional study of adult patients, who presented with at least one ESR equal or higher than 100 mm/h at Hospital Italiano, in Buenos Aires (Buenos Aires, Argentina) between January 2002 and August 2014.', 'In a retrospective analysis of prospectively acquired single-center, observational data, we evaluated 4673 consecutive patients who underwent SE from 1983 to 2009.']


Cluster  1131
['While the significance of obesity as a serious health problem is well recognized , little is known about whether and how biometerological factors and biorhythms causally contribute to obesity .', 'Participants (BMI ≥25\u2009kg/m<sup>2</sup>, waist circumference\u2009≥88 cm) were randomly assigned to MOD-C (20-30\u2009min at 60-70% of heart rate reserve(HRR)) or VIG-SIC (5-7 repeated bouts 30-second maximal effort sprints, followed by four minutes of active recovery) supervised training three days/week for six weeks, with each group matched on energy expenditure.', 'Under energy-balanced conditions, exercise performed in a post-absorptive state increases 24-h fat oxidation in female subjects.', 'The objective of the study was to evaluate the effect of a short-term weight reduction program on the metabolic status and plasma AA levels in individuals with obesity.', 'This is the first report that as short a duration as 4-week aerobic exercise plus dieting decreased serum chemerin in obese female adolescents, which might be associated with the improvement in glucose and lipid metabolism, mitigation of inflammation and decrease in MetS incidence, thus lowering cardio-metabolic risk, while no health benefit resulted from slight dieting.', 'Elevated plasma resistin, apelin, chemerin, and visfatin levels in morbidly obese patients are gradually reduced after weight loss.', 'Similar to previous observations in women, our data indicate that cardiorespiratory fitness assessed by bicycle ergospirometry test is associated with glucose and lipid metabolism in severely obese men.', 'Our study aims to systematically assess the effects of regular exercise for overweight and obese gravidas, which will be provided clinical guidance for overweight and obese gravidas.']


Cluster  1762
['Food insecurity remains highly prevalent in developing countries and over the past two decades it has increasingly been recognized as a serious public health problem , including in Ethiopia .', 'Child wasting is a severe public health problem in the predominantly rural population of Ethiopia : A community based cross-sectional study .', 'The burden of food insecurity and malnutrition is a severe problem experienced by many poor households and children under the age of five are at high risk .', 'Malnutrition remains a serious concern in Rwanda , particularly among children under-5 years .', 'Poor nutritional status of women has been a serious problem in Ethiopia .', 'In Ethiopia , child undernutrition continues to be a serious public health problem .', 'Mortality of children with severe acute malnutrition ( SAM ) is a devastating problem in Ethiopia .', 'Childhood malnutrition is still a serious worldwide public health problem and its consequences are particularly severe when present during early life .', 'Child undernutrition is a serious public health problem in many low- and middle-income countries .', 'Nutritional deficiencies in children represents a serious public health problem in Bom Jesus , Angola .', 'Childhood undernutrition is a serious public health problem in South Africa .', 'Malnutrition in children under 5 years of age ( U5s ) is a serious public health problem in low- and middle-income countries including Bangladesh .', 'Childhood overnutrition is a serious public health problem , with consequences that extend into adulthood .', 'Though Ethiopia has implemented different nutritional interventions , childhood stunting on which literature is limited continues as a severe public health problem .', 'Undernutrition is a serious global problem that contributes to increased child morbidity and mortality , impaired neurocognitive development , and decreased educational and economic attainment .']


Cluster  998
['CIN is a serious and global problem in patients receiving cancer therapy .', 'This is a randomized clinical trial of women with CIN2.', 'Seven definitive CIPO patients (2 males and 5 females) were enrolled.', 'In RIPC group, CIN occurred in 28% of cases, while in sRIPC - 3.', 'Increased serum CIRP concentrations clearly reflect SAP severity and prognosis and significantly distinguish SAP, substantializing CIRP as a potential SAP biomarker.', 'Serum CIRP concentrations were significantly higher in patients compared to controls.']


Cluster  115
['However , a serious dilemma results from the fact that these two structures are from topologically different families of helical duplexes .', 'The lack of description of van der Waals interactions in layered materials such as graphite and binary graphite intercalation compounds remains a main drawback of conventional density functional theory .', 'A major drawback of the widely successful density functional theory is its underestimation of the material band gap .', 'This , most probably , is in contradiction with its observed optical transparency and expected insulating behavior and points toward a serious density-functional theory problem .', 'Finally , we highlight a severe drawback of tuned range-separated hybrid functionals by discussing the example of the calculation of bond-length alternation in polyacetylene , which leads us to point out the challenges for future developments in this field .', 'A detailed analysis of a severe intruder state problem in the multistate multireference perturbation theory ( MS-MRPT ) calculations on the ground state of manganese dimer is presented .', 'From different initial conformations , helical conformations were reached and the multiple energy minima did not become a serious problem .', 'The broadening of the stability diagram at the βy = 0 boundary also enabled the observation of fragment ions with higher mass-to-charge ratios ( m/z ) than the m/z of the precursor ions thus overcoming a major drawback of BAD of multiple-charged ions .', 'The main problem with kissing bond defects in FSW , is that they currently are very difficult to detect using existing NDT methods .', 'In the case of [3(6)]CP 2 , the most stable C(6)(h ) structure was observed in the crystal structure of the 2-TCNQ-F(4 ) ( 1:1 ) complex , whereas the highly strained structure with a D(6)(h ) symmetry was observed in the crystal structure of 2 and the 2:TCNQ : benzene ( 1:1:1 ) complex because of a severe disorder problem .']


Cluster  358
['Cross-lagged path analyses revealed a direct intervention effect of P2G on academic engagement at Time 2.', 'Therefore, the aim of this study was to examine whether an innovative customized school-based group intervention could improve core executive functions (updating, inhibition, and shifting) in the age group concerned.', "The study is a randomized control trial (RCT) where two pedagogical methodologies were tested to evaluate how they enhanced children's language, executive functions and attention, socioemotional skills, and early maths skills during an intensive 6-week intervention.", 'This intervention study suggests that teacher-child interactions predict academic engagement over time, which in turn improves language achievement among preschool boys at risk of externalizing behaviour.', 'In a sample of 175 preschool boys showing signs of externalizing behaviour (M<sub>age</sub> \xa0=\xa04\xa0years, 9\xa0months, SD<sub>age</sub> \xa0=\xa07\xa0months) and their teachers, we investigated P2G effects on academic engagement as well as on language achievement.', 'The purpose of this study was to test the motor learning effects of KP among boys with ADHD.', 'The evidence base for behavioural activation (BA) is mainly grounded in the individual delivery method, with much less known about the impact of group delivery.', 'This study examined the therapeutic effects of self-regulated learning on reducing challenging behaviors and enhancing school-related function in children with autism spectrum disorders.', 'Forty children (aged 6-12) were randomized into a 12-week Self-Regulated Learning or Activity-Based intervention control group.', 'PKP feedback improves motor skill performance learning among children with ADHD above knowledge of results feedback only.', 'The Self-Regulated Learning intervention was more effective compared to the Activity-Based intervention with particular benefits for on-going learning and improvements.', '(1) To compare and evaluate the effectiveness of customized tell-play-do (TPD) technique with live modeling for behavior management of children.']


Cluster  1346
['The results suggest that SMS technology for HIV and TB should be used to transmit reminders for appointments, medications, motivational texts, and health education to increase retention in care.', 'Trained subjects were less susceptible to SMS, with symptom scores reduced by 40%.', 'The results of this weight loss trial support the use of smartphone technology and feedback from a health coach on improving weight in a group of diverse young adults.', 'Future research is needed to determine optimal frequency and duration of post-TKR SMS to support patients who have undergone TKR.', 'The smartphone application-based program significantly improved serum phosphorus, potassium, self-efficacy and quality of life over time compared with the general program.']


Cluster  2163
['Pain is a serious problem for patients with leg ulcers .', 'Our data show that most patients with venous leg ulcers are not able to apply effective compression therapy with short-stretch bandages to themselves.', 'In total, 40 patients with chronic venous leg ulcers were included in the study.', 'In all, 100 consecutive patients with venous leg ulcer were asked to apply compression bandages on their own leg.']


Cluster  582
['This is a serious public health problem requiring a programme of mass education and case identification and management in all health facilities .', ', has become a serious public health problem .', 'They pose a serious medical , surgical , and public health problem .', 'They have been recognized worldwide as a serious public health problem .', 'This indicates a severe public health problem throughout the country .', 'This would become a serious public health problem .', 'This is a serious public health concern as it indicates a dual burden of disease .', 'STB remains a severe public health problem that can not be ignored .', 'It represents a serious problem for public health .', 'The result is a serious public health dilemma .', 'These phenomena can lead to harmful behaviours , including violence , thus representing a serious public health concern .', 'The high rate for these events prompted dissatisfaction among local healthcare parishioners , keenly aware that they constitute a serious Public Health problem .', 'This is a serious health problem which needs to be dealt with by a national health education programme .', 'These events constitute a serious Public Health problem .', 'This would create a serious public health problem .', 'To avoid a serious threat to public health , academia , biotechnology and pharmaceutical industry , regulators , and healthcare providers must find solutions to this problem .', 'It constitutes a serious public health problem that affects the entire society .', 'Being a serious public health problem with multiple causes , only a cross-sectorial and concerted action could contribute to their resolution .', 'It represents a serious global public health problem .', 'They are a serious global health problem with social , interpersonal , and legal interpolations .', "It has become a serious public health concern , threatening people 's health ."]


Cluster  370
['The presence of airborne microorganisms in indoor air ( home and work ) is a serious public health concern .', 'Fungal contamination of materials is a serious human health problem because the fungal cells scatter from the materials in the air or HD .', 'Deterioration of indoor air quality ( IAQ ) has become a serious concern as people spend lots of time indoors and prolonged pollution exposure can result in adverse health outcomes .', "Der p 1 (78 (30,82) ng/g) was the dominant dust mite allergen in air samples of patients' bedroom as well as static collections.", 'Respiratory allergy triggered by exposure to environmental chemical allergen is a serious problem in many Asian countries and has the potential to cause severe health problems .', 'Recently , Asian dust ( AD ) has become a serious health problem and several studies have clearly proven that AD can aggravate asthma .', 'Combustion materials emitted from combustion space heating appliances in housing during the winter may become a serious problem to health , since sources of ventilation are usually left closed to obtain a comfortable temperature level .', 'HEPA air purifiers can effectively reduce PM and HDM allergen concentration in the indoor air, and thereby improve clinical manifestations of patients with AR.', 'The installation of a negative air-ionizer in the horse stable did not reduce concentrations of dust, endotoxin, and viable fungal spores.', 'With dense population and rapid economic development of China , air pollution is still a serious problem and the prevalence of eczema has been elevating .']


Cluster  770
['The low-volume Clensia is equally effective and safe in bowel cleansing compared to the standard PEG 4L, with better gastrointestinal tolerability and acceptability.', 'Simethicone swallowed with water prior to MCE produced the optimal gastric mucosal image quality.', 'Prospective measurements of RGV were performed in patients undergoing esophagogastroduodenoscopy (EGD) and morning colonoscopy with split-dose PEG preparation, patients undergoing EGD and afternoon colonoscopy with same-day PEG preparation, and patients undergoing EGD alone under moderate conscious sedation.', 'To examine the residual gastric volume (RGV) in colonoscopy after bowel preparations with 3-L polyethylene glycol (PEG).', 'PEG bowel preparations increase RGV mildly, but seem to have no clinical significance.', '120 patients referred for MCE were randomly assigned to gastric preparation with either water alone (A), water with simethicone (B) or water, simethicone and pronase (C).', 'To demonstrate the equivalence of a new low-volume PEG containing citrates and simeticone (Clensia) versus a standard PEG 4L.']


Cluster  313
['To compare consecutive patients treated with MT alone or with preceding IVT in a large tertiary neurointerventional center, with special emphasis on contraindications to IVT.', 'Sixty individuals with TTH diagnosis who referred Neurologist were incorporated into study.', 'Implementing the protocol, there was a reduction of death rate of patients with severe TBI and aftereffects in patients with moderate TBI.', 'This study found that RHE did not improve the neurological outcomes in patients with STBI.', 'SLI decreased the need for ETT in the DR (21% versus 55%, p\u200a<\u200a0.', 'TTE patients who received a combination of posterior lateral and anteromedial approach or other conservative treatments were included in the present study.', 'To evaluate the value of MRI findings, neurologic assessment and the Slump test (neurodynamic test) as predictors of treatment response to TESI.', 'This study investigated the feasibility, tolerability and clinical utility of tDCS in patients with MCI.', 'RVI is a serious ED problem because morbidity and mortality is higher in acute MIs associated with RVI .', 'Thirty-six patients with TBI were randomly divided into the intervention group and placebo group.', 'We analyzed 480 patients (227 males) from two centers: group 1 consisted of 162 patients with time-defined TIA; group 2 of 315 patients with negative brain DW-MRI (tissue-based TIAs).', 'All AIS patients who underwent MT at our tertiary neuroscience unit between January 2018 and March 2020 were retrospectively reviewed.', 'DTI presents a serious problem in the clinic , as it is often not visible until reaching an advanced stage .', 'A prospective observational study with MRI was performed regardless of the level of consciousness in post-CA patients treated with TTM.']


Cluster  883
['Acne, a common pediatric disease, tends to be more comedonal in preadolescents, whereas older individuals are more likely to have inflammatory lesions in addition to comedones.', 'Of the 112 patients of persistent acne, 40 (34.', 'AMH is a good tool to diagnose PCOM in persistent acne patients and can be used as a replacement for TV-USG, although it does not correlate with hyperandrogenemia.', 'Acne vulgaris is a common inflammatory skin condition which is treated using Tretinoin (TRE), a widely used retinoid.', 'This double-blind, placebo-controlled study randomized 40 adult patients with 10-25 comedones per half face to once-daily application of Acne RA-1,2 or placebo for 8\xa0weeks.', 'The study was conducted with 104 adolescents with acne and 102 age- and sex-matched healthy controls.', 'Acne vulgaris is a common chronic skin disease that affects around 9', 'Of the 251 women enrolled, 59\xa0% had grade 1 acne at baseline; 31\xa0%, grade 2; and 10\xa0%, grade 3; the most commonly affected area of the body was the face (IGA grades\xa02 or 3: 79\xa0%).', 'Adolescents with acne were found to have lower levels of self-esteem and life satisfaction and higher levels of loneliness compared to controls.', 'Open-label study including subjects aged ≥12\u2009years with mild-to-moderate facial acne; ClinicalTrials.gov Identifier: NCT02589405.', 'In the Acne RA-1,2 group, there was a significant 35% decrease in the mean number of comedones from 26 at baseline to 17 at Week 8 (P<.', 'Acne vulgaris and hirsutism are important signs related to hyperandrogenaemia and present a serious medical problem for the patients and a challenge for medical doctors in terms of effective treatment .', 'To investigate on the prevalence, clinical features and treatments of acne in 9 to 14-year-old patients.', 'Sixty-two percent believed that acne is not a serious problem , while 56.7 % consider it as both a cosmetic and health problem .', 'Acne vulgaris is a common disease of the pilosebaceous unit.', 'The aim of the study was to compare the hormonal profile of persistent acne patients with or without PCOS and to assess the role of AMH (antimullerian hormone) in persistent acne patients.', 'Acne remains a severe problem for both patients and clinicians .', 'Acne is not a rare disease in pre-adolescent age.']


Cluster  41
['Reduction mammaplasty was associated with postoperative physical fitness improvements among US Army active duty women.', 'No significant differences in trunk muscle endurance, lung function, or self-rated physical function were found after abdominoplasty with vs without plication.', "Because abdominoplasty flap's major vascularization is suprafascial, some surgeons perform excision of the deep fat pad below Scarpa's fascia to achieve a better abdominal contour and balance the lower abdominal projection above and below the scar.", 'We performed a prospective case series study, operating 74 consecutive women using an otherwise standard abdominoplasty technique, and recorded patient variables, flap dimensions, and complications.', 'A series of 125 people were randomised to abdominoplasty with or without rectus abdominis muscle plication.', 'Using the Stanford Military Data Repository, we identified 89 US Army active duty women with at least 1 pre- and postoperative Army Physical Fitness Test (APFT) who underwent reduction mammaplasty during 2011 to 2014.']


Cluster  420
['They also achieve better performance than the baseline system using the telicity feature alone . they ignore edge type information', 'One drawback is that LMF provides only a specification manual with a few examples', 'They also achieve better performance than the baseline system using the telicity feature alone . they ignore edge type information', 'We present a comprehensive benchmarking tool that is easy to implement, requires minimal expense and allows specific adjustment of LP parameters for optimisation of LP performance.']


Cluster  929
['A history of smoking was found in 90 patients (88%), while 43 patients (42%) had pulmonary dysfunction.', 'In conclusion , smoking is a serious problem after OLT and increases the risk for malignancy .', 'Among 2,216 participants who smoked 5-19 cigarettes per day at baseline and exercised at leisure time, vitamin E supplementation reduced the incidence of pneumonia by 69% (95% confidence interval [CI]: 43%-83%; 57 pneumonia cases).', 'Aerobic training improved autonomic balance despite the continued smoking.', 'The most important patient factors associated with IA rupture are smoking and EBP.', 'At pre-intervention, smokers had significantly higher high sensitive C-reactive protein than non-smokers.']


Cluster  575
['The incidence of transfusion was significantly different between centres for THR (range 7 to 95%), total knee replacement (range 3 to 100%) and CABG (range 20 to 95%).', 'In this retrospective observational study, 557 KT recipients who did not receive perioperative plasmapheresis and who did not exhibit graft failure within 1\xa0month after KT were included.', 'The main problem with the use of conventional NO donors is that they affect blood pressure and flow , and for these reasons , they can not be used safely in clinical practice .', 'However , when a severe health problem occurs in a donor while the recipient has already received a conditioning regimen , hematologists have to find the best solutions for the recipient , while the team in charge of the donor has to find the best medical solutions for the donor .', 'To date , however , no study has provided any psychosocial follow-up of donors who developed a serious health problem such as end-stage renal disease ( ESRD ) .', 'ESDT demonstrated slightly higher increments at 24 h after transfusion in late recipients, suggesting this could be a cost-effective approach for the treatment of thrombocytopenic multitransfused hemato-oncological patients.', 'In the early-recipients cohort, 24-h-posttransfusion increments were available for 29 ESDT patients and 6 standard patients, and did not differ significantly between the groups (p = 0.', 'The recipient and donor characteristics were similar except in cold ischemia time; it was higher with Celsior.', 'The age, gender, BMI and VVR did not significantly contribute to the volume of fluid shift following donation.', 'Fluid shifts from interstitial to intravascular space during blood donation helps in compensating the lost blood volume.', 'A positive donor management goal Bundle status change during donor hospital management is associated with a 2-fold increase in achieving ≥4 OTPD.']


Cluster  503
['Domestic family violence ( FV ) is a serious problem with serious impacts on mental health of victims .', 'Domestic violence , a serious health problem , affects millions of people every year .', 'Given the small number of adult women in Yap , these findings suggest that domestic violence is a serious , pervasive problem that Yap needs urgently to address .', 'Domestic violence is a serious problem with far-reaching consequences .', 'Only recently has Japanese society come to realize the magnitude of domestic violence as a serious social problem .', 'Domestic violence ( DV ) is a serious problem all over the world which had been extended to boundaries of countries , economical , cultural and racial classes .', 'Violence against women is a serious problem in Turkey .', 'Domestic violence is a serious and often underreported problem .', 'One-in-three women has experienced domestic violence , which is a serious public health problem and a human right violation .', 'Domestic abuse is a serious problem that may present directly or indirectly in the clinical setting .', 'These results underscore that domestic violence is a serious problem that must be addressed in Thai society .', 'It is concluded that physical violence among married women is quite high and a serious problem .', 'The study concludes that wife beating is a serious health and social problem for the women population of Kantale .', 'Domestic abuse of women is a serious problem worldwide that has economic , physical , and psychological consequences , yet in many countries and cultures , victims often have little access to psychological support .', 'The magnitude , physical and mental health consequences of domestic violence represents a serious reproductive health concern for Pakistan .', 'The Canadian government has introduced numerous policies , guidelines , and mandates at the federal and provincial levels that recognize woman abuse as a serious social problem and violation of the law .', 'Although domestic violence ( DV ) is recognized as a serious crime , only recently has it been acknowledged as a critical public health problem .', "Domestic violence is a serious women 's health and societal problem .", 'Domestic violence is a serious and highly prevalent concern among this group of South Asian women .', 'Domestic violence ( DV ) is a serious public health problem in the world .', 'Domestic violence and partner violence against women is a serious problem in many countries , including Germany .', 'The data about domestic violence against women point out a serious problem all around the world along with including cultural differences .', 'Domestic violence is a serious , complex , public health problem , which is more common than many physicians realize .']


Cluster  208
['The aim of this study was to determine the impact of a decision-making application on antibiotic prescription.', 'Frequent and inappropriate use of antibiotics in primary health care settings in China is a serious problem that likely contributes to antimicrobial resistance worldwide .', 'In conclusion , inappropriate antibiotic use is a serious problem in primary medical institutions in China .', 'This study indicates that antibiotic abuse is a severe problem in China and that judicious use of antibiotics is urgently needed .', 'Abuse of antibiotics for ARI is a serious and costly problem in rural China , potentially leading to widespread antibiotic resistance .', 'Inappropriate use and overuse of antibiotics is a serious concern in the treatment of upper respiratory tract infections ( URTIs ) , especially in developing countries .', 'They were also more likely to agree that antibiotics were not useful for upper respiratory tract infections and that antibiotic resistance was a serious local problem .', 'An antibiotic protocol in the app can help antibiotic stewardship reducing cost, changing the microbiological profile and antimicrobial consumption.', 'The high prevalence of keeping antibiotics at home and SMA among young adults is a serious concern .', 'Between October 2014 and September 2015 (period B), a specialist in infectious diseases (ID) controlled all antimicrobial prescriptions and decided about the therapy in agreement with gastroenterologists.', 'Antibiotic abuse can lead to antibiotic resistance , which is a severe problem in China .']


Cluster  892
['TMD symptomatology is unrelated to alterations in craniocervical position (C0-C1 distance and craniocervical angle).', 'The mean length of the manubrium, the length of corpus sterni, the length of total sternum, SI, sternal angle were found in females 46.', 'To analyze the relationship between the position of the upper cervical rachis and the symptoms of TMD.', 'The nutrient foramens exist in 97% of the left lamina and 93% of the right lamina of the C2 vertebra.', 'ANOVA showed that the TMD and control women had similar C1-C0 distances and craniocervical angles (p> 0.']


Cluster  1344
['Twenty-three children (mean age: 4.', 'Twenty-one children (median age 2.', 'Of the 80 children, 53.', 'Twelve young women (19.', 'In total, 135 children aged 6.', 'Sixty-five children (36 boys and 29 girls, mean age: 9.', 'A total of 683 children (49.', 'Four girls and four boys aged 10.', 'We recruited 160 English secondary schools (approx.', 'In total, 118 ten- to twelve-year-old school children were recruited from eight participating classes.', 'Nine men and 13 women were included; 16 were initially S<sub>1</sub> , one S<sub>3</sub> , and five S<sub>4</sub> .']


Cluster  383
['Moreover , alignments in each term are many-to-one , namely , multiple instances from ck can be aligned to the same vb \\u2208 cl in the first term and likewise in the second term . there is only a limited amount of visual clues that can be used to distinguish individual components from each other and cognitive overload restricts how many annotation schemes can be viewed at the same time', 'But we also believe that ultimately this issue of annotator bias', 'The main problem with the XBank Browser is that there is only a limited amount of visual clues that can be used to distinguish individual components from each other and cognitive overload restricts how many annotation schemes can be viewed at the same time', "For instance , 4 % of MUC 's and 5.9 % of BBN 's PER entities have wordtype Aaa A. Aaa , e.g. The current HOO annotation scheme does not have the granularity to systematically identify all function word errors –", 'Moreover , alignments in each term are many-to-one , namely , multiple instances from ck can be aligned to the same vb \\u2208 cl in the first term and likewise in the second term . there is only a limited amount of visual clues that can be used to distinguish individual components from each other and cognitive overload restricts how many annotation schemes can be viewed at the same time', 'The problem with rich annotations is that they increase the state space of the grammar substantially', 'Another shortcoming of our approach is that it requires us to be disciplined in our pass/overgeneration annotations', "For instance , 4 % of MUC 's and 5.9 % of BBN 's PER entities have wordtype Aaa A. Aaa , e.g. The current HOO annotation scheme does not have the granularity to systematically identify all function word errors –", 'The only shortcoming is the cost of annotation']


Cluster  377
['This study shows clear effects of PEWS on SA among professionals.', 'Our study confirms the safety of SAE.', 'The percentage of PSA tests that were not carried out as SHI services was >\u202f80% in general practices, and 60% in urological practices.', 'Fifty parturients planned for elective CSs under SA were enrolled in this prospective, double-blinded, controlled study and randomly divided into two equal groups.', 'In about half of more than 50,000 PSA tests, the accounting category could be determined; the rest could only be assigned to SHI or non-SHI services.', 'Twenty-three patients underwent SAE according to the protocol.']


Cluster  1343
['As is evident from table 3 , there is a significant bias for ten-star reviews . the dataset contains only those acronyms whose long-forms were found in Medline abstracts', 'As is evident from table 3 , there is a significant bias for ten-star reviews . the dataset contains only those acronyms whose long-forms were found in Medline abstracts', 'As is evident from table 3 , there is a significant bias for ten-star reviews . the dataset contains only those acronyms whose long-forms were found in Medline abstracts']


Cluster  2275
['This was a non-interventional, open-label, multicentre, prospective study in patients for whom the decision had already been made to initiate treatment with etanercept during routine practice in German centres.', 'To investigate the addition of low-dose methotrexate as a means to increase etanercept drug survival.', 'The mean duration of drug-free intervals was relatively short, most patients experienced improvements in disease activity and health-related quality of life within 12 weeks of either continuous or intermittent treatment with etanercept, and there were no new safety signals.', 'Data from 3 placebo- (PBO) or PBO- and etanercept (ETN)-controlled trials were integrated.']


Cluster  1613
['This multicenter, double-blinded, randomized trial compared twice daily topical 0.', 'Enrolled patients were randomly allocated to receive topicalA.', 'Clinically, oclacitinib delayed development of dermatitis at the site of allergen application.', "Respondents' tolerance for side-effect risks varied with side-effect severity and location of plaques, and risk tolerance for serious side-effects was greater for patients than for dermatologists.", 'Subjects achieving various levels of skin clearance (PASI 90-100 or PASI 75-89) and Dermatology Life Quality Index (DLQI) (0/1) response were compared using ERASURE and FIXTURE trial data.', 'A sample of 85 patients was recruited, of which 67 were used to assess the effectiveness of the treatment with topical cetirizine, while 18 were control patients.', 'A prospective observational study of 176 consecutive outpatients aged 60 years and older, who attended a consultation in the department of dermatology of Helsinki University Central Hospital.', 'We recruited 800 patients with active chronic skin diseases.', 'To evaluate the efficacy of topical desoximetasone 0.', 'The data for analysis were obtained from the electronic health and patient record database and patient files of the Photodermatology Unit, Department of Dermatology, Medical University of Graz, Austria.', 'The objective of this study was to identify whether a predefined group of dermatologic conditions under the heading "pseudobacterial"-including eczematous conditions, arthropod assault, herpes zoster, neurodermatoses, autoimmune blistering disorders, and neutrophilic dermatoses-are associated with increased antibiotic use prior to dermatology referral.', 'A total of 21 healthy volunteers with normal to oily skin were enrolled in this study.', 'This physician survey provides new evidence on topical access and the influence of disease severity on topical usage in an effort to improve treatment strategies on a global level.', 'A prospective, multicenter study was performed at 3 private dermatology clinics.', 'Previously patch-tested, surfactant-positive patients were identified via chart review and invited to participate.', 'The study was a retrospective, descriptive, and analytical study conducted at the Dermatology Outpatient department of the University Hospital of the West Indies.']


Cluster  1508
['Cervical cancer ( CC ) is a malignant tumor which for many years has been a serious epidemiological problem in Poland .', 'Cervical cancer is a serious public health problem in South Africa .', 'Cervical cancer has posed a serious problem in Thailand for decades .', 'Cervical cancer (CC) is one of the leading cause of death in women worldwide, HPV infection is the major risk factor in the disease development, 0and however other risk factor such as chemical carcinogens, genetic susceptibility and altered immune system are also a cause of the disease progression', 'Cervical cancer ( CC ) is classified as the fourth most common type of cancer in women worldwide and remains a serious public health problem in many underdeveloped countries .', 'Cervical cancer is a serious health problem , with nearly 500000 women developing the disease each year worldwide .', 'Cervical cancer is a serious public health problem with high geographical variations in incidence , mainly due to historical patterns of risk factors and the influence of screening activities .', 'Cervical carcinoma represents a serious medical and social problem .', 'Cervical cancer constitutes a serious public health problem in Poland as well as worldwide .', 'Cervical cancer continues to be a serious public health problem in the developing world , including China .', 'Cervical cancer is a serious public health problem in developing countries .', 'Cervical cancer represents a severe public health problem and has been associated to the presence of human papillomavirus .', 'Although in developed countries the incidence of cervical cancer seems to be declining , it remains a serious health problem .', 'Despite screening , cervical cancer ( CC ) remains a serious health care problem .', 'Cervical cancer is a serious problem in developing countries because it is usually not detected at an early stage .', 'Uterine cervical cancer in Latin American women is a serious health problem .', 'Cervical cancer in women during pregnancy and puerperium is a serious diagnostic and therapeutic problem .', 'Cervical cancer is a preventable public health problem .', 'Cervical cancer is a serious public health problem in Thailand .', 'Cervical cancer ( CC ) is a serious public health concern in Serbia , due to opportunistic screening still being in force , which led to twice higher than the average incidence rate of cervical cancer in Europe .', 'Cervical cancer remains a serious public health problem in the world ; that is why the Mexican Federation of Schools of Obstetrics and Gynecology convened the elaboration of a consensus that is devoted this number of Ginecologia y Obstetricia de Mexico .']


Cluster  733
['A serious drawback of the treatment is that a significant proportion of men do not reach azoospermia or severe oligozoospermia , commensurate with contraceptive efficacy .', 'The problem with the prophylaxis is that the activities listed should be carried out all life long , but the effects , particularly by primary prevention , can not be seen till later .', 'If semen analysis was postponed from 6 to 9 months after surgery , a total yearly saving of 6,153.23 Euro would be observed in our setting , but with the drawback of delaying the diagnosis of azoospermia in nearly 60 % of men .', 'POP is not a life-threatening condition , but a functional problem that impairs quality of life for women .', 'The problem with condom-based approaches , however , is that physicians are often unaware of the limitations in the protection provided by condoms from sexually transmitted infections .', 'However , whether patients who have hypoalbuminaemia are susceptible to the development of POP is a serious concern , although it has not been investigated .', 'A major drawback of the polypill is that there are limited data demonstrating its safety and efficacy in the prevention of cardiovascular morbidity and mortality .', 'The adherence benefits of polypills tend to offset the loss of potency from use of individual components with lower dose potency, and to facilitate improvements in multiple risk factors.']


Cluster  1156
['The main types of cancer were breast (57.', 'Breast cancer continues to be a serious public health problem .', 'Breast cancer is a serious health problem worldwide .', 'Breast cancer continues to be one of the most common malignancies and is a serious problem particularly in women , although men may also be affected .', 'Breast cancer is a common cancer and becomes a severe healthy problem among females .', 'Breast cancer represents a serious public health problem worldwide , for its high incidence , morbidity , mortality , and its high cost treatment .', 'Breast cancer is the most common female cancer and remains a serious public health concern worldwide .', 'With such a high incidence , breast cancer is a serious health concern for all American women .', 'The high morbidity and mortality of breast cancer among women is a serious problem .', 'Breast cancer is a troublesome health problem , particularly among underserved and minority women .', 'Breast cancer remains a serious public health problem globally .', 'Breast cancer is a serious health problem worldwide .', 'Preventable deaths resulting from the scourge of breast cancer has become alarming and worrisome in many societies in developing countries, including Nigeria', 'Introduction : Currently breast ( BC ) cancer is a serious medical problem in all countries of the world .', 'Breast cancer (BC) is a common malignancy in women', 'Breast cancer is a serious problem in the developed world , and the common perception of the risks of developing the disease are communicated to the public via a variety of means .', 'Breast cancer is a serious health problem .', 'Breast cancer ( BRCA ) is a serious public health problem , as it is the most frequent malignant tumor in women worldwide .', 'Breast cancer in the United States continues to be a serious public health problem that affects individuals , families , and society .', 'Breast cancer is a serious health issue and a major concern in biomedical research .', 'Breast cancer is a serious health problem worldwide , representing the second cause of death through malignancies among women in developed countries .', 'Breast cancer is the most prevalent cancer among women']


Cluster  722
['A total of 121 consecutive, unrelated, index PCC/PGL patients underwent genetic testing for five PCC/PGL susceptibility genes (RET, VHL, SDHB, SDHD and SDHC) and were evaluated for clinical diagnosis of neurofibromatosis type1 (NF1).', 'To define the types and frequencies of hair findings in individuals with Proteus syndrome.', 'We analysed DNA of 31 girls with idiopathic CPP diagnosed via basal LH levels >\u20090.', 'Overall, the prevalence of NPM1 and FLT3-ITD mutations was found to be 14.', 'Although this disease poses a serious health problem in our population , the genetic alterations that lead to the development of NPC have yet to be defined .', 'The problem with PHP is that it is almost certainly a heterogeneous condition encompassing a number of defects within the PTH receptor-adenylate cyclase complex .', 'A cross-sectional study was conducted of individuals with clinical features of Proteus syndrome and a confirmed pathogenic variant in AKT1 evaluated between November 1996 and June 2019 at the National Institutes of Health Clinical Center.', 'As for other G protein-coupled receptors (i.e. GPR54), mutations in PROKR2 do not seem to be a frequent cause of CPP in girls.']


Cluster  1983
['For suffix separation , we identify a number of linguistic rules for both Tamil and English . in assigning an induced word cluster to a known target category , such as noun , and evaluating the goodness of the cluster according to how well it represents the class noun , the assumption is made that it is fine for a target class to be represented by multiple induced clusters , but it is unacceptable for a single induced category to represent a combination of multiple target categories', 'For suffix separation , we identify a number of linguistic rules for both Tamil and English . in assigning an induced word cluster to a known target category , such as noun , and evaluating the goodness of the cluster according to how well it represents the class noun , the assumption is made that it is fine for a target class to be represented by multiple induced clusters , but it is unacceptable for a single induced category to represent a combination of multiple target categories', 'Both rule-based and statistical stemmers have been developed for a variety of languages . unknown words', 'Variation across languages can to a large extent be explained by the proportion of unattached tokens that should be attached to the artificial root node . they fail to recognize terms which are not included in the dictionary', 'The probabilities of alternative assignments are within some small specified distance . morphotactics was explicitly raised to the level of the sentence grammar , hence the categorial lexicon accounted for both constituent order and the morpheme order with no distinction', 'Both rule-based and statistical stemmers have been developed for a variety of languages . unknown words', 'We wanted to determine , insofar as was possible , whether there was a group consensus as to where the segment boundaries should go . we focus mostly on unitary sources of overgeneration : a single lexical item , tree property or derivation operation that consistently occurs in overgenerated strings', 'We believe that it is essentially related to the different morphemes corpus of Chain1 and Chain2 . word ambiguity', 'This point is particularly important to handle compounds in morphologically rich languages in which retrieval of the independent forms from compound elements is not straightforward , such as Russian . it can not bridge vocabulary gaps between documents and queries', 'The methodology is more fully described by Power , Scott , and Bouayad-Agha -LRB- 2003 -RRB- . their inability to properly take into account subcategorization frames ( SF ) of predicative lexemes2']


Cluster  765
['This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses.', 'The aim of this study was to assess the comparative effectiveness of TBL and lecture-style classes in terms of teaching core competencies in nursing education, which include clinical competence skills, problem-solving ability, communication competencies, critical thinking ability, and self-leadership.', 'This study investigated the effectiveness of a modified hybrid brainstorming (MHB) program against conventional brainstorming (CB) to achieve idea generation during innovation initiatives in nursing', 'Coaching is a relatively new application to promote the development of leadership skills in health care and nursing', 'This paper explicitly addresses circulating nontechnical skills needed to support the design of educational and training pathways for nurses.', 'Design in use and inventiveness are key concepts in ergonomics', 'Competency of staff nurse preceptors is an essential factor that determines the success of preceptorship experiences', 'Nontechnical skills of circulating nurses can be described using five categories: leadership, situation awareness, task management, communication, and teamwork.', 'The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient.']


Cluster  1645
['• Cerebrovascular disease represents a major source of global mortality and morbidity • Imaging examinations play a critical role in the management of stroke patients • The penumbra may be seen with both CT and MRI ; however , this concept may be overly simplistic • The major drawback of CT is the high radiation dose , while MRI is a more complicated examination .', 'Extensive acute hypoxic/ischemic MRI lesions in the cortical regions, deep gray matter and cerebellum detected by visual analysis as well as low apparent diffusion coefficient values from quantitative measurements were associated with poor outcome.', 'A drawback of time-resolved 3-dimensional phase contrast magnetic resonance ( 4D Flow MR ) imaging is its lengthy scan time for clinical application in the brain .', 'The silent stroke or white matter abnormalities in the vicinity of the lateral ventricle observed in CT or MRI have become a serious clinical problem and these are generally considered risk factors for stroke .', 'The report emphasizes the hazard of relying on a nondiagnostic CT scan in a septic patient with deteriorating neurological function , and the need of MRI with contrast enhancement if subdural empyema is a serious clinical concern .', 'Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS.', 'Brachial-ankle pulse wave velocity is predictive of silent cerebral embolisms on diffusion-weighted magnetic resonance imaging after carotid artery stenting.', 'Our results indicated that the diagnosis of TP highly suggests premorbid or comorbid structural lesions in the central nervous system, including old stroke.', 'Reliable evaluation of cerebral blood flow might not be possible with angiography and basic MRI alone.']


Cluster  2263
['Lesions were most frequently located in the head and uncinate process of the pancreas (60.', 'They emphasise the fact that such lesions , though usually not constituting a serious clinical or diagnostic problem , as a simple sonographic follow-up will suffice to clarify the situation , may nevertheless , in certain particular clinical situations such as in the course of tumour staging of the digestive apparatus , require full diagnostic investigation using all the techniques available ( ultrasonic tomography , CAT , liver arteriography , sonographically guided thin-needle biopsy .', 'Differentiation between neoplastic and inflammatory pancreatic tumors very often remains a serious clinical problem .', 'Differentiating between mucinous cystic tumors ( MCTs ) and serous cystic tumors ( SCTs ) can be a troubling diagnostic dilemma in pancreatology : when SCTs present in their macro-oligocystic form they must be resected because MCT can not be ruled out , and some tumors considered benign are actually MCTs , which delays diagnosis and places patients at increased risk .']


Cluster  1638
['Diabetic renal disease is a serious problem resulting from microvascular complications in both type 1 and type 2 diabetes mellitus .', 'With worldwide epidemic of diabetes mellitus , diabetic nephropathy which is one of the major causes of microvascular complication has become a serious concern in Korea as well as the rest of the world .', 'Diabetic nephropathy ( DN ) is a serious complication of diabetes mellitus ( DM ) , which is a major public health problem in the world .', 'Diabetes mellitus is a debilitating health care problem affecting 382 million people around the world and one of the most common complications is diabetic nephropathy .', 'Nowadays diabetic nephropathy ( DN ) has become a serious problem .', 'Diabetes mellitus is a serious health problem in the world and about 20 to 40 % of the patients are being affected with diabetic nephropathy .', 'With a developing worldwide epidemic of diabetes mellitus , the renal complications associated with diabetes have become a serious health concern .']


Cluster  545
['When manual assays of antithrombin-III with use of different synthetic chromogenic peptide substrates are modified for a centrifugal analyzer , the downward deflection of the reference curve at the zero point raises a serious problem , because the position of the zero value is included in the calculation of the reference curve .', 'We compared the performance of 2 HemoCue® models (Hb-201+ and Hb-301) and investigated effects of preanalytical factors on Hb results by simulating unfavorable field conditions.', 'Thus , hemolyzed specimens are a serious pre-analytical problem calling for well-designed and strictly implemented laboratory guidelines .', 'Differences between calculated and measured hydrogen carbonate concentrations can pose a serious problem not only in monitoring severely ill patients , but also in those on hemodialysis .', 'Maximal intraprocedural TcPCO2 values and minimal oxygen saturation did not differ significantly between the KPM and FPM groups (63.', 'In clinical laboratory practice , hemolysis can be a serious problem due to its potential to bias detection of various analytes or biomarkers .', 'Because quantitative CBF and CMRO(2 ) values are sensitive to arterial input function , it is necessary to obtain accurate input function and a drawback of this approach is to require separation of the measured arterial blood time-activity curve ( TAC ) into pure water and oxygen input functions under the existence of residual radioactivity from the first injected tracer .', 'In our study, we assume that the measurement of CO by IPc using the PHYSIOFLOW® system is as accurate as TD or using the direct Fick method in patients with PH in group 1 or group 4.', 'A Bland-Altman plot showed that the average difference between noninvasively obtained hemoglobin and laboratory hemoglobin concentration was -0.']


Cluster  548
['Interviews with 18 married women with high interpersonal dependency were coded using thematic analysis.', 'Findings revealed that at baseline there were multiple complex explanations and interpretations about discordance among discordant couples and their surrounding community.', 'We show that MS is associated with an increased risk of divorce among men, but not women.', 'Some individuals are no longer entering romantic relationships, others move through relationships too quickly searching for "the one" and making quick assessments of their romantic partners, while others stay in their relationships but "check out" or do not work on their issues', 'Females had higher levels of anxiety and depression than males both at admission and after discharge.', 'Multiple regression analysis identified the following statistically significant confounders : victimization , the presence of a person with a severe health problem at home , female sex , engaging in limited physical exercise , and living in a single adult family .', 'Financial disagreements have been identified as a severe source of discord in adult relationships , yet limited work has considered whether financial considerations contribute to conflict among younger samples .', 'These findings presented a relatively clear understanding of the impacts of interpersonal dependency on the sexuality of Iranian women.', 'Women with EDS scores equal or higher than 13 also reported a higher occurrence of recent stressful life events-specifically , death or a serious problem with a close friend or relative , unemployment , financial problems , and moving or housing difficulties .', 'At baseline, a significant difference was seen between the groups depending on the existence of a spouse.']


Cluster  747
['Treatment of anal incontinence in children with a pathology of the distal portion of the spine is a serious problem .', 'Fecal incontinence ( FI ) is a devastating problem for children .', 'Urinary incontinence in children is a distressing problem that often is magnified during puberty , since the children then realize the full significance of the disorder .', 'Fecal incontinence is a debilitating problem for many children , especially those with anorectal malformations .', 'Fecal incontinence is a prevalent pediatric condition with psychosocial impacts on both children and their caregivers.', 'The CINCY-FIS is a reliable and valid assessment of pediatric fecal incontinence-specific quality of life and parenting stress.', 'Urination impairments in children with neurological disorders are a serious clinical problem .', 'Fecal incontinence is a debilitating and highly prevalent problem among multiple sclerosis patients .']


Cluster  1194
['The differences between the values obtained with the 3 assay kits presented a serious problem in clinical use of PA .', 'GP time spent on key prescribing activities significantly reduced by 51% (79 hours, <i>P</i><0.', 'Eradication therapy was prescribed due to dyspepsia (66.', 'PASI25 achievement at week 4 (odds ratio\xa0=\xa08.', 'The primary end point, the mean reduction in PLA grade from baseline to Day 106 was 1.', 'The decrease in PIP was significant after the fifth, tenth, and 15th sessions ( P < .', 'Different trials on PEP have yielded varying results.', 'The pVAS scores and yeast counts were significantly reduced on D28 compared with D0 in both groups (P\xa0<\xa00.', 'PASI score continually decreased with time on ponesimod treatment, reaching a plateau at 16 weeks.', 'Our study showed no statistically significant difference between the two groups in PASI reduction and PASI 75 achievement, even though the fixed dose was often lower (range 2.']


Cluster  543
['A major problem with this study was that the data did not show good simple structure and meaningfulness because no rotation was performed for the canonical variates .', 'The problem with these studies is that prevalence proportions can not be compared with each other , because of differences in performance of each survey .', 'The misconception about the Papanicolaou test is a serious educational problem , as demonstrated by the present study .', 'Our own data replicate previous findings of poor reliability for traditionally used scores , which suggests a serious problem with the ability to test theories regarding attentional bias .', 'One potential problem with its use in the UK is that the test has been standardised on American children .', 'The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment .', 'The major problem with the method using the CGA data is that it can not accommodate inter-subject differences .', 'A problem with this research is that each study demonstrated a different measure of social support to be the detrimental factor .', 'Results of the first study showed substantial variation between graders, with kappa agreement as low as 0.', 'The study failed its primary endpoint.']


Cluster  1981
['The two studied groups showed comparable demographic data and years of work.', 'Patient demographics of the 2 groups were comparable.', 'Background characteristics of the two groups were closely matched.', 'Demographic and clinical features of the groups were similar.', 'Patient characteristics between the groups were similar.', 'The groups were similar regarding sociodemographic background and medical history.', 'Both groups were comparable for distribution of age and parity and presence of imminent symptoms and eclampsia.', "Patients' background was similar between the CT and non-CT group.", 'Clinical backgrounds were similar.', 'Overall, the initial population was similar in the two groups.']


Cluster  347
['Forty-two boys with severe ID (M<sub>age</sub>= 9.', 'A total of 134 children were randomized into two groups.', 'One hundred and thirty-two children benefited from RT in that period and were included (70\xa0patients until 2008, 62\xa0after 2008).', 'Twelve children from a care-center were included in this preliminary study.', 'We randomized 75 children to a multidisciplinary intervention or to a standard care program.', 'In this prospective randomized study, children aged 2-12 years were assigned to one of the three study groups.', 'A one-group baseline/poststudy design with 40 adolescents recruited from two pediatric tertiary care centers was used.', 'Seventy children each were randomized to the treatment and placebo groups.', 'The majority of children 38/40 (95%), of the intervention group, took the seeds for 3-9 consecutive months.', '12 children with ABI (study group - SG; mean age\u2006=\u200612.', 'Among 8319 children (4437 intervention/3882 control), 652 nonaccidental outpatient consultations occurred (322 intervention/330 control).', 'We found that the estimated percent of at-risk adolescents who were successfully screened in each clinic varied widely between clinics with a mean of 14.', 'Two hundred and fifty-four children were randomized (N = 127 test, N = 127 control).', 'Twenty-two children were included, 17 completed the study protocol (nine and eight for the control and the OF:IN group, respectively).', 'Thirty-one boys with ADHD, randomly selected into either a treatment or a control group, completed a series of cornhole games.', 'Fifty-three children and adolescents (10.', 'In an observational study, 122 nonanemic children (age 4.']


Cluster  1982
['Horizontal transfer of antibiotic resistance genes carried by conjugative plasmids poses a serious health problem .', 'Instability of bacterial cloning vectors can present a serious problem when direct selection for plasmid-encoded phenotypes is undesirable , ineffective or impractical .', "Transfer of aac(6')-aph(2″ ) transposons mediating high-level gentamicin resistance ( HLGR ) in Enterococcus faecalis is a serious problem in the clinic .", 'The rapid spreading of polymyxin E ( colistin ) resistance among bacterial strains through the horizontally transmissible mcr-1 and mcr-2 plasmids has become a serious concern .', 'Its ability to acquire and transfer resistance genes and virulence determinants through conjugative plasmids poses a serious concern for public health .']


Cluster  185
['Ocular lesions have been reported in patients with schistosomiasis ; however , the problem with studying schistosomal infection of the human eye is that biopsies are almost impossible to take , and histopathological examination of suspicious lesions can only be undertaken post-mortem or after enucleation .', 'Our study is the first to demonstrate a statistically clinical objective improvement of clinical symptoms of scleromyxoedema with IVIg.', 'Complete cytoreduction was achieved in 12 of 13 patients by the second CRS.', 'The completeness of cytoreduction is one of the most important prognostic factors for patients with pseudomyxoma peritonei (PMP)', 'The cytologic diagnosis of ASCUS is a serious dilemma both clinical and considerable economic problem .', 'Cyst fluid CEA and CA 72.', 'Scleromyxedema (SME) is a rare mucinosis associated with monoclonal gammopathy']


Cluster  2242
['Obesity is increasing worldwide at an alarming rate . Particularly in Western countries , obesity and related problems have become a serious medical problem and an enormous socio-economic burden .', 'Obesity is a serious global health problem , perhaps the biggest public health issue of our times .', 'Obesity is a severe medical problem endangering the health of individuals worldwide .', 'Increasing prevalence of overweight and obesity is a serious social and health problem both in the economically developed and developing countries .', 'The increasing number of people suffering from metabolic syndrome and obesity is becoming a serious problem not only in developed countries , but also in developing countries .', 'Obesity is a serious public health problem , the prevalence of which is increasing dramatically all over the world .', 'Here , the trend is still increasing : Overweight and obesity do not only pose a serious health problem in industrialized nations , but increasingly also in developing countries .', 'Obesity is a serious public health problem throughout the world , affecting both developed societies and developing countries .', 'Obesity is a serious health problem in the Western societies , therefore its treatment has become the subject of intense interest in the scientific community .', 'Obesity is a multifactorial chronic disorder which comprises a serious health problem nowadays .', 'Obesity , especially early onset of obesity is a serious health concern in both developed and developing countries .', 'Obesity is a serious and rapidly growing health problem worldwide .', 'Morbid obesity has grown enormously in recent decades , representing a serious public health problem .', 'Obesity is a serious public health problem that is growing alarmingly worldwide .', 'Obesity is now a serious , emerging problem in developing countries .', 'In the 21st century , obesity has become a serious problem because of increasing obese patients and numerous metabolic complications .', 'The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem .', 'Obesity is a serious public health problem , and the increasing prevalence of overweight status in the population is a major concern worldwide .', 'Obesity is a serious chronic disease and a public health concern in both developing and developed countries .', 'Morbid obesity and its rapidly increasing prevalence has became a serious health , social and economic problem not only in Europe , but in other developed countries in the Western world .', 'The prevalence of obesity has been increasing sharply and has become a serious public health problem worldwide .', 'Nowadays , obesity is considered as a serious and growing global health problem .', 'Obesity is a serious problem facing patients and healthcare providers around the globe .', 'Obesity is expected to become a serious social problem in Asia-Oceania in the next two decades , so we need to prevent a corresponding increase of NASH .', 'Obesity is a serious public health concern with an increasing prevalence worldwide .', 'Obesity has become a severe health problem in the Western world , and is rapidly becoming the most common disease of the 21st century .', 'The epidemic nature of obesity in industrialized countries is a serious health and social concern .', 'Obesity is a serious and growing public health problem in the United States and the world .', 'Obesity is a serious health problem in industrialized countries and is associated with a significant increase in total health care costs .', 'Obesity has become a serious epidemic health problem in both developing and developed countries .', 'Obesity has become a serious public health problem that has stimulated primordial and primary prevention efforts , and a triad of management options ( lifestyle , pharmacotherapy , and surgical interventions ) .', 'Obesity is a serious and growing world healthy problem affecting developed and developing countries .', 'Obesity is a serious problem for modern medicine .', 'Obesity is a serious health problem worldwide , particularly in developed countries .']


Cluster  1712
['Ad infections are a serious problem for solid-organ transplant recipients and AIDS patients as well .', 'Skin and soft tissue infections among the non-human immunodeficiency virus infected immunosuppressed population are a serious and growing concern .', 'While resistance is not a serious issue for immunocompetent individuals , it is a real concern for immunocompromised patients , especially those with AIDS and the ones that have undergone organ transplantation .', 'Disseminated adenoviral infection is a serious problem , especially in an immunocompromised host .', 'Currently this disease no longer represents a serious problem , it has a minimal morbidity and no mortality ; only the group of high risk immunosupressed patients ( AIDS , HIV ( + ) , ADVEP ) shows an increase in the number of cases and management in these patients continues to be problematic .', 'While resistance is not a serious issue for immunocompetent individuals , it is a real concern for immunocompromised patients , especially those with AIDS and the ones that have undergone organ transplantation .']


Cluster  486
['The aim of this study was to classify pediatric patients with DM based on pancreatic autoimmunity and the presence or absence of overweight/obesity, and to compare the clinical, anthropometric, and biochemical characteristics between children in the different classes of DM.', 'Aim of this study was to assess the lipid status of the patients of pediatric rheumatologic diseases (pRDS).', 'We performed a randomized, double-blind, two-way cross-over study, including 58 children with type 1 diabetes, aged 14.', 'Twelve of 148 young participants with European ethnic backgrounds (8%) were identified by the risk prediction model as likely to have MODY; four had a glucokinase gene mutation.', 'During a summer camp, 25 children with T1D on pumps estimated the number of carbohydrate (CE) and fat/protein exchanges (FPE) appropriate for main meals.', 'In adolescents, LMM was associated with higher CMR, regardless of nutritional status.', 'As exchange counting poses difficulty for children with type 1 diabetes (T1D) attending diabetes camps, they often guesstimate food amount without performing an exchange calculation.', 'Diabetes is a serious health problem for pediatrics .']


Cluster  942
['Dirhodium-catalyzed insertion of nitrene species into C-H bonds is a promising new method , the main drawback of which is the currently limited understanding of the catalytic mechanism .', 'The problem with the classical reassortment procedure used to generate LAIVs is that there is limited selection pressure against NA of the Len/17-MDV resulting in 7:1 reassortants with desired HA only , which are not suitable LAIVs .', 'The problem with the first mechanism is that the second step produces 12 mol of hydrogen ions per mole of nitrogen fixed and the third step consumes 10 mol of hydrogen ions per mole of nitrogen fixed .', 'Arcs labelled N and S lead to a nucleus or satellite , respectively . the difficulty of matching their goals to the given options']


Cluster  71
['Treatment with oxymatrine or acitretin for 8 weeks significantly decreased PASI score, skin classification grade and DLQI score (P < 0.', 'Both sides of the face showed significant improvement of acne lesions but improvement was significantly higher and earlier in sides treated by combination peels.', 'To evaluate and compare the clinical efficacy and safety of combination chemical peels vs single peel in treatment of mild-to-moderate acne.', 'PDT combined with isotretinoin has higher effective rate and lower recurrence rate than single PDT, and is a choice for the treatment of moderate to severe acne.', 'Assessment of the efficacy of azelaic acid 20\xa0% cream (Skinoren<sup>®</sup> ) on acne severity and disease-related QoL.', 'Our findings suggest that topical JAK inhibitors could be developed as a potential new treatment for AA and alternative to clobetasol dipropionate 0.', 'Patients with mild to moderate actinic keratoses on forehead and scalp were treated with methyl aminolaevulinate (MAL)-PDT and aminolaevulinic acid (ALA)-PDT on two similar areas of forehead and scalp.', 'This study demonstrates that serial GA peels in combination with a MKF are efficacious and safe in the treatment of facial PIH in dark-skinned patients.', 'The aim of this study was to investigate the efficacy of 50% glycolic acid peeling performed at different phases of menstruation on acne.', 'Latanoprost, minoxidil and betamethasone valerate are effective and safe in the treatment of patchy AA.', 'Compared with minocycline alone, the combination of PDT with minocycline significantly improved clinical efficacy and QOL in moderate to severe facial acne patients.', 'Fifty-five women with photoaging were randomized in 2 treatment groups: (1) Daily application of the antiaging cream for 8\xa0weeks or (2) Three sequential GA peels (20%, 50%, and 70%), 2-3\xa0weeks apart.', 'Twenty-two subjects completed the clinical study and demonstrated statistically significant improvement by Day 60 in actinic keratosis, overall skin appearance, wrinkling, dyschromia, erythema, and texture (p < .']


Cluster  730
['Atrial and ventricular dysrhythmias developing after cardiac operation further reduce cardiac output , posing a serious problem for postoperative management .', 'With more than a third of patients expected to endure the arrhythmia at any given time point , atrial fibrillation after cardiac surgery becomes a vexing problem in the postoperative care of cardiac surgery patients .', 'Postoperative atrial fibrillation ( AF ) is a vexing problem in cardiac surgery .', 'In spite of advances in the management of bleeding associated with cardiac surgery , hemorrhage remains a troublesome problem , particularly in complex cases and high risk patients .', 'Bleeding is a serious concern during surgery for acute aortic dissections .', 'Postoperative stroke remains a serious problem in cardiovascular surgery .', 'Postoperative stroke constitutes a serious problem in cardiac surgery , and atherosclerosis of the ascending aorta is an important risk factor .']


Cluster  397
["A related limitation is that its model of the speaker 's goals is static , rather than dynamic ( e.g. , the speaker is always assumed to have a goal of being polite )", 'A disadvantage is that each request involves the overhead of starting a new Prolog process , and a consequently inflated response time , as well as complex arrangements to maintain dialogue state information', "The accuracies are presented by the `` micro averaged '' F-score . an adaption to a different dialogue system or to new modalities is quite expensive", 'One widely acknowledged limitation is that the use of reference answers makes it impossible to compare systems that use different dialog strategies for carrying out the same task', 'The effect of smoothing is indeed always stronger for learner 1 than learner 2 . the use of reference answers makes it impossible to compare systems that use different dialog strategies for carrying out the same task', 'A potential shortcoming of the one-step model is that the probability distribution over dialogue acts is prone to distortion depending on the portion of NoMove in the training data', 'A first limitation is the n-gram simulations only use a window of n moves in the dialogue history', 'However , the drawback is that an adaption to a different dialogue system or to new modalities is quite expensive', 'Each rule now has the form3 : the probability distribution over dialogue acts is prone to distortion depending on the portion of NoMove in the training data', "The accuracies are presented by the `` micro averaged '' F-score . an adaption to a different dialogue system or to new modalities is quite expensive"]


Cluster  320
['This prospective study indicates a high incidence of adverse events of transfusion in Kumasi, Ghana.', 'However , plasma exchange needs fresh frozen plasma or another protein fraction from humans , and virus contamination or other infectious factors are a serious problem .', 'Haemoglobin threshold for transfusion has been significantly decreased, but haemoglobin plasma concentration may not be sufficient to assess the need of red-blood-cell (RBC) transfusion.', 'Transfusion-related bacterial contamination is a serious problem .', 'Transfusion-related acute lung injury ( TRALI ) is a life-threatening problem that can occur during blood product transfusion in patients of any age .', 'Furosemide is not routinely ordered for RBC transfusion, even in patients with risk factors for TACO.', 'Current methods of transfusion education employed in the UK are unsatisfactory to ensure safe transfusion practice.', 'There is a global call for increased transfusion education for doctors to support the delivery of evidence-based practice.', 'Patients with severe anemia , allo- and autoantibodies , either showing hemolysis in their pathophysiology or not , cause a serious problem in any transfusion center , especially when dealing with emergencies .', 'Transfusion is an irreversible event that carries potential risks as well as benefits to the recipient.', 'To provide evidence-based guidance on how transfusion education should be delivered to junior doctors by employing established qualitative research methodology.', 'This prospective observational 1-year study enrolled 372 recipients of 432 transfusions in a Ghanaian teaching hospital.', 'Pathogen reduction technology using amustaline (S-303) was developed to reduce the risk of transfusion-transmitted infection and adverse effects of residual leucocytes.', 'A retrospective observational study was carried out in the Department of Transfusion Medicine in our hospital from March 2013 to December 2015.', 'Transfusion-transmissible infections , human immunodeficiency virus , hepatitis B virus , hepatitis C virus , and syphilis are among the greatest threats to blood safety and pose a serious public health problem .', 'However , because of transfusion-induced infectious diseases , the safety of serum products is a serious concern .']


Cluster  290
['A mixed-method explanatory sequential design.', 'An observational (non-experimental) design was used.', 'A mixed methods observational study.', 'We utilized a mixed methods analysis to explore four aims.', 'A qualitative observational pilot study with a mix-method design.', 'A prospective, cross-sectional, observational design was employed.', 'The study used an observational design.', 'This study used a participant observation design.', 'The mixed-methods approach used a quasi-experimental pretest-posttest design with an intervention and control group and thematic analysis of focus group data.', 'Observational design.', 'A cross-sectional, observational design.']


Cluster  1311
['People with intellectual disabilities are thought to have a reduced capacity for understanding death', 'The end of life represents a therapeutic context that acutely raises cultural and linguistic specificities, yet there is very little evidence illustrating the importance of such dynamics in shaping choices, trajectories and care practices', 'Previous research has indicated that culture can have a significant impact on the stroke caregiving experience', 'Brainstem death presents families with a paradoxical death that can be difficult to define', 'If , as Karol Wojtyla had insisted , the human person is fundamentally irreducible to any natural , biological , social , or even cosmological function , then the diagnosis of death on any of the purely functionalistic grounds available to medical science presents a serious ethical problem .', 'Whilst literature indicates that culture impacts on end-of-life decision-making significantly, there is limited evidence on the topic', 'The results showed that , despite the humanization discourse , reflected in the prerogative of living the final moments of life with the family , a serious problem in the discontinuity of care is concealed .']


Cluster  1788
['Olive mill wastewater ( OMW ) , a liquid by-product of the olive oil industry , represents a severe environmental problem owing to its high pollution load .', 'Olive mill wastewaters ( OMW ) pose a serious environmental concern owing to high polyphenol content .', 'Wastewater from the olive mill constitutes a serious environmental concern , as it is characterized by a high inorganic and organic load .', "This activity , however , may represent a serious environmental problem due to the discharge of highly polluted effluents , usually referred to as ' olive mill wastewaters ' ( OMWs ) .", 'The contamination of soils with dry olive-mill residue can represent a serious problem as being an environmental stressor in plants .', 'Olive mills wastewater ( OMW ) causes a serious environmental problem in the olive oil producing countries .', 'Olive mill effluents constitute a serious environmental problem in the Mediterranean Sea region due to the unique features associated with this type of agro-waste ( i.e. seasonal and localized production , high and diverse organic load , low flow rates )']


Cluster  1595
['Anastomotic leakage remains a devastating problem for the patient , and a continuing challenge to the surgeon operating on high-risk areas of the gastrointestinal tract such as the esophagus and rectum .', 'Anastomotic leakage (AL) is one of common complications after esophageal cancer surgery.', 'Esophageal leak is a life-threatening problem that can result from spontaneous rupture of the esophagus , cancer , anastomotic dehiscence after surgery , or as a complication of endoscopy .', 'Anastomotic leak after colorectal surgery , which remains a serious clinical problem that causes augmented morbidity and mortality , is usually favored by ischemia .', 'Anastomotic leak from cervical esophagogastric anastomoses is a serious problem after esophagectomy .', 'Anastomotic stricture causing recurrent dysphagia is a serious problem occurring in patients after total oesophagectomy and cervical oesophagogastrostomy .', 'This was a prospective, observational study of patients from January 2005 to May 2019 with an esophageal anastomotic leak that were treated with a self-expandable stent (SES).', 'Esophagogastric anastomotic stricture following esophagectomy with a gastric esophageal substitute can be a vexing problem for the patient and treating physician .', 'Anastomotic leakage is a serious complication after colorectal surgery , and many risk factors for this problem have so far been identified .']


Cluster  1687
['In clinical practice, malocclusion is often encountered during the period of growth and development of individuals.', 'Although malocclusions represent a serious public health issue , there is insufficient information about this problem in adolescents in Brazil , especially in poorer areas .', 'Our results confirmed that malocclusion has become a serious oral health problem in Chinese schoolchildren , highlighting the need for proactive interventions at an early age .', 'Chronic oral malodor is a serious concern for about one-fifth of the North American population , and a field of emerging research interest .', 'At least 50 per cent of the population suffer from chronic oral malodor , however , and approximately half of these individuals experience a severe problem that creates personal discomfort and social embarrassment .', 'One hundred and eight malocclusion patients (46 adults and 62 children at the school-age) were randomly selected and received orthodontic treatment with fixed orthodontic appliances.']


Cluster  1919
['Star-freeness of the constraints is a minor restriction when compared to the finiteness of this language . the large search space faced by the decoder', 'Star-freeness of the constraints is a minor restriction when compared to the finiteness of this language . the large search space faced by the decoder']


Cluster  1102
['Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage .', 'LC is the treatment of acute cholecystitis, with consensus recommendation that patients should be operated within 72\u200ahours of evolution.', 'Phase 1 included a retrospective analysis of possible complications documented on standard consent forms for laparoscopic cholecystectomy.', 'Eleven laparoscopic cholecystectomies performed by consultant surgeons and specialty trainees at a London teaching hospital were audio and video recorded.', 'One hundred and twenty-eight patients who underwent cholecystectomy comprised the study group.', 'The Finnish version of the RAND-36 survey can be used as a valid and reliable method for measuring the quality of life and long-term outcome of cholecystectomy patients following surgery.', 'Acute cholecystitis ( AC ) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery ( OHS ) , due to its aggressive course ; therefore , AC should be treated as soon as possible .', 'Eighty patients who were scheduled for elective laparoscopic cholecystectomy surgery were enrolled in this prospective study.', 'Although single-incision laparoscopic cholecystectomy (SILC) has no advantage over conventional laparoscopic cholecystectomy (LC), except for better cosmesis, few reports have discussed the criteria for SILC.', 'Single-blind controlled clinical trial with 16 surgeons who performed 2 laparoscopic cholecystectomies, the first according to standard practice and the second with warm-up comprising 5 MISTELS system exercises.', '183 patients with diagnosis of cholecystolithiasis postoperated of laparoscopic cholecystectomy had their bile sent to bacteriology.', 'Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group.', 'A total of 57 patients were randomly divided into two groups and submitted to conventional laparoscopic cholecystectomy (n=29) and laparoscopic cholecystectomy by single access (n=28).', 'Cholecystolithiasis is a serious problem of contemporary medicine .', 'ELC for acute cholecystitis even beyond 72\u200ahours of symptoms is safe and associated with less overall morbidity, shorter total hospital stay, and duration of antibiotic therapy, as well as reduced cost compared with delayed cholecystectomy (NCT01548339).', 'Final analysis included 168 (79%) elective cholecystectomies and 44 (21%) emergent procedures.', 'The aim was to assess the 8-year health status after minicholecystectomy (MC) versus laparoscopic cholecystectomy (LC) for gallstone disease (GS) by using the RAND-36 Health Survey.', 'In this prospective, single blinded randomized controlled trial, subjects were 132 adult patients, hospitalized in the General Surgery clinics and underwent laparoscopic cholecystectomy of a Training and Research Hospital in Turkey.', 'With 700,000 cholecystectomies performed in the US , annually , about 280,000 patients are left with symptoms , making this a serious problem .', 'Patients scheduled for cholecystectomy were assigned to undergo LC or SIOC performed by surgeons in two different expert groups.', 'The aim of this study was to compare clinical outcomes of early versus delayed laparoscopic cholecystectomy (LC) in acute cholecystitis with more than 72\u200ahours of symptoms.', 'In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.']


Cluster  1071
['We enrolled MS inpatients (EDSS 4.', 'In Study 1, twenty participants with MS were screened for HA and assigned to either a high or low HA group.', 'We present a study design and rationale for randomizing a nonpharmacological intervention for MS-associated fatigue, using bright light therapy.', 'Evaluate several versions of visual acuity and contrast sensitivity tests, measures of central and peripheral vision, retina structure, electrophysiologic function, and quality of life among MS patients with moderate/severe visual dysfunction.', 'Cross sectional design was used in patients with MS.', 'Eligible participants will have clinically confirmed multiple sclerosis based on the revised McDonald criteria (2010) and a score ≥36 on the Fatigue Severity Scale (FSS).', 'Depression and balance were found frequent and associated in people with MS.', 'Ninety-one participants with MS (age: 47.', 'To investigate the association between depression and balance impairments in people with MS.', 'Among MS patients with visual impairment due to optic neuritis, PR contrast sensitivity could be utilized as a single chart.', 'Individuals with MS (n\u2009=\u2009230) were randomly assigned to two types of patient education-educational brochure (control) and OSE (intervention).']


Cluster  1552
['Peripheral nerve injury ( PNI ) is a serious public health problem that is linked with motor , sensory and autonomic deficits .', 'Peripheral nerve involvement has been described at alarming rates in some studies , which increases the chance of deformities , a serious problem , especially if one considers the age of these patients .', 'Peripheral neuropathy ( PN ) is a serious problem affecting more than 22 million people in the United States , according to The Pacific Chapter of the Neuropathy Association .', 'Peripheral nerve injury is a serious medical problem and severely affects normal life of patient .', 'Nerve injury , especially the large-size nerve damage , is a serious problem affecting millions of people .', 'Sensory polyneuropathy can be a serious problem , but for the majority of clinically important neuropathies there are no available therapies .', "Peripheral nerve injury is a serious problem affecting significantly patients ' life ."]


Cluster  1432
['However , the shortcoming of both approaches is that they ignore edge type information', 'A drawback of this method is that the speed of optimal path computation depends on image size .', 'The main drawback is that structures may not be properly represented by flat features', 'A drawback of MI is that it only takes into account the intensity values of corresponding pixels and not of neighborhoods .', 'A drawback of this method is that images are 2D projections in which information is invariably obscured by overlap of atoms .', 'The main shortcoming is that exact inference is intractable for those dynamically generated segment level features', 'However , a major drawback of this method is that all pixels are updated by the projection , even when only a few pixels are corrupted by noise or occlusion .']


Cluster  211
['Serotonin is a marker for decompensation in patients with chronic heart failure.', 'Depression is common in patients with ischaemic heart disease and preoperative depression is a risk factor following coronary artery bypass grafting.', 'Plasma serotonin levels were significantly elevated in decompensated HF patients compared with stable patients (P=0.', 'We introduced a depression screening project at the cardiac surgery department at Karolinska University Hospital and included patients between 2013 and 2016.', 'Depression following acute coronary syndrome ( ACS ) constitutes a serious and debilitating problem .']


Cluster  566
['Owing to its association with infertility , EjD is a serious concern , particularly in men of reproductive age .', 'Male dog infertility may represent a serious concern in the canine breeding market .', "The optimal timing of intracytoplasmic sperm injection ( ICSI ) is of a serious concern for fertility programs because untimely sperm entry diminishes the egg 's developmental competence .", 'This observational, comparative study included 16 sub-fertile men who required intracytoplasmic sperm injection and 10 fertile men.', 'Our hope is that with increasing experience with microinjection , in the near future , this type of infertility will not remain a serious problem .', 'Sexual precocity is a serious problem because of genetic retrogression , which has negative effects on product quality and dramatically affects price .', 'Declining reproductive performance is a serious breeding concern in many countries .', 'A serious problem with the latter assumption is that those spermatozoa lack DNA repair .', 'Reproductive dysfunction and malignancies related to the male gender represent a serious health concern , whose incidence has significantly risen over the past years .', 'Despite the advances in male infertility microsurgery in China , the lack of standardized and well-organized training programs for male infertility microsurgery remains a serious problem affecting its development .', 'A further limitation with BPH models is that prostatic hyperplasia similar to the human condition does not occur spontaneously or can not be induced in any suitable animal species .', 'These results confirm the role of suPAR as a protein marker of MAGI and support the hypothesis that hypogonadism induces a state of inflammation in male accessory glands which is involved in male infertility.', 'Achieving ejaculation was a serious problem   for the patients in whom the lowest increases in testosterone and 5 alpha-DHT levels were observed after HCG stimulation .']


Cluster  1476
['There were statistically significant differences in rates of overall and exclusive breastfeeding, initial breastfeeding experience, breastfeeding behaviour and self-efficacy between the two groups at 3 and 42\xa0days postpartum (p\xa0<\xa0.', 'Although the Internet-based peer-support intervention had no effect, the importance of breastfeeding attitude for the duration of breastfeeding in mothers of preterm infants was shown.', 'The intent-to-treat analysis showed significantly higher percentages of breastfeeding mothers in the incentive group at each time point compared with those in the control group (89% vs 44%, <i>P</i> = .', 'The duration of overall breastfeeding was on average 3·0 and 4·3\xa0months, in the experimental and control groups respectively.', 'Breastfeeding at 30 days showed a nonsignificant trend favoring the control group (OR, 7.', 'To determine the effects of an individualised mixed management combined lactation education and psychoeducation intervention on breastfeeding outcomes and postpartum depression (PPD) at 3 and 42\xa0days postpartum.', 'The results demonstrate the effectiveness and feasibility of delivering an individualised mixed management intervention combining lactation guidance with psychological support during pregnancy.']


Cluster  640
['Crime victimisation is a serious problem in psychiatric patients .', 'Traumatic victimization , particularly sexual abuse , is a serious problem in correctional facilities and those suffering from mental illnesses are especially vulnerable .', 'To study the prevalence of restraint in a Indian psychiatric inpatient unit, and to examine the level of perceived coercion correlating to various forms of restraint.', 'Psychostimulant abuse is a serious health and societal problem in industrialized and developing countries .', 'Patients absconding from psychiatric hospitals pose a serious concern for the safety of patients and public alike .', 'Thus , sexual coercion is a serious and prevalent concern among female Indian psychiatric patients , but is rarely reported in medical charts .', "Psychiatric boarding , defined as psychiatric patients ' waiting in hallways or other emergency room areas for inpatient beds , is a serious problem nationwide .", 'Victimization of persons with severe mental illness is a serious medical and social problem .', 'Identity theft is a serious problem in the United States , and persons with enduring mental illnesses may be particularly vulnerable to becoming victims of this crime .']


Cluster  1434
['African Americans shoulder significant disparities related to hypertension ( HTN ) , which is a serious public health problem in the city of Detroit , Michigan , where more than 80 % of the population is African American .', 'African American women, aged 18 to 45 years, with untreated prehypertension and Internet access were eligible for a 12-week study that incorporated social cognitive theory strategies.', 'The culturally relevant cardiovascular health promotion program presented to cluster groups of rural African American participants had positive influences on psychosocial variables associated with engaging in cardiovascular health recommendations.', 'Hypertension is a serious health problem in Western society , in particular for the African-American population .', 'Racial health disparities related to hypertension in African Americans are a serious public health concern that warrants greater attention .', 'The purpose of this study was to evaluate a culturally relevant cardiovascular health promotion intervention that could potentially reduce cardiovascular disease risk among a group of rural African American adults by improving intentions, attitudes, norms, and self-efficacy to increase produce consumption, reduce dietary saturated fat intake, and increase exercise.']


Cluster  9
['Injecting MSCs via blood vessel is most commonly used method , which has a major drawback of safety .', 'Between January 2007 and December 2013, a total of 200 patients who received complete revascularization of three-vessel disease with either first-generation DES (n=85) or new-generation DES (n=115) were analyzed in this retrospective study.', 'Compared with second-generation DES for PCI of CTO lesions, BRS were associated with lower rates of technical and procedural success.', 'In BRPC, arterial involvement was associated with impaired outcome regarding resection rate and survival, possibly due to the difference in the underlying pathophysiology between BR-V and the advanced nature of BR-A as a systemic disease.', 'These findings indicated that in patients with three-vessel disease, PCI with new-generation DES is associated with a significantly increased event-free survival rate of MACE at 3years as compared to first-generation DES.', 'Arterial repair after SES implantation caught up with BMS at around 8years with regards to NSC, although prevalence of YP and MT remained still greater in SESL than BMSL at extremely late phase.', 'SRSs released spontaneously within 4\xa0days after insertion (p\u2009=\u20090.', 'Thirty-seven SES and 17 BMS were implanted into 22 and 9 patients with angina pectoris, respectively.']


Cluster  999
['The aim of this study was to determine the relationship of the salivary levels of dehydroepiandrosterone sulfate (DHEA-S) and cortisol with factors related to depression and anxiety in patients with hyperemesis gravidarum (HG).', 'Salivary cortisol and DHEA-S levels, as well as mood disorders, should be monitored in patients with HG, although further large, prospective studies are needed to confirm our results.', 'Adrenomedullin and galanin concentrations were similar between genders and did not change following adoption of the standing posture.', 'To report the components of biological and analytical variability in serum cortisol concentration post-ACTH stimulation ([cortisol]) in healthy dogs.', 'Baseline plasma concentration of adrenomedullin (5·35 ± 0·74 (n = 12, females) vs.', 'The GBM group had more severe clinical signs and significantly different total serum cholesterol concentration and post-ACTH stimulation cortisol concentration at the time of diagnosis.', 'Plasma cortisol early-morning and midnight (AM/PM) ratios negatively correlated with 24-h urinary free cortisol (UFC) collections among the full study population and in each of the individual etiologies.']


Cluster  1287
['Early administration of nicorandil distal to the vascular lesion during PCI in STEMI patients may reduce the incidence of reperfusion injury, and improve short-term clinical outcomes.', 'This randomised controlled trial involved 170 STEMI patients who underwent PCI.', 'A total of 11,428 STEMI patients were included in the study.', 'An observational study based on a permanent registry of reperfusion strategies and timing among patients treated in a French general hospital for STEMI with chest pain lasting for less than two hours.', 'We retrospectively studied all patients presenting with STEMI to our center between 1995 and 2014.', 'Half of the present STEMI patients did not achieve DTB time ≤90 min.']


Cluster  2230
['Homelessness among older African American women is emerging as a serious social problem .', 'Although substance abuse has for many years been documented as a serious problem among homeless populations , there is as yet no clear understanding of the nature of the relationship between substance abuse and homelessness .', 'Evictions are increasingly recognized as a serious concern facing low-income households .', 'Although homelessness has been recognized as a serious and growing urban social problem , scientifically acceptable methods for estimating the composition and size of the homeless population have been lacking .', 'Homelessness is a serious problem in the Northern Territory , and is associated with poor health outcomes .']


Cluster  2244
['In veterinary practice , frequent treatment of closed populations has led to a serious problem of anthelminthic drug resistance which is now largely irreversible .', 'Drug resistance in gastrointestinal nematodes is a severe problem for sheep farmers .', 'Findings provided strong evidence that anthelmintic resistance is a serious problem on small ruminant farms throughout the southeastern United States .', 'Unfortunately , IVM resistance is now a serious problem for parasite control in livestock and there is a concern about resistance development and spread in nematode parasites of humans .', 'Anthelmintic resistance is a serious concern to the effective control of GIN parasites and has fuelled the focus to design and promote sustainable control of practices of parasite control .', "Haemonchus contortus constitutes a severe problem for ruminant 's production , it is the most frequent nematode parasite both in template and tropical regions , induces economical losses , and shows increasing resistance to currently available anthelmintics .", 'Gastrointestinal nematodes are considered a serious economic problem affecting the livestock industry around the world .']


Cluster  2302
['To effectively capture photoplethysmographic ( PPG ) signals , a multi-wavelength opto-electronic patch sensor ( OEPS ) together with a schematic architecture of electronics were developed to overcome the drawback of present PPG sensor .', 'The results of the BioMonitor 2 Pilot study confirm the excellent sensing amplitudes afforded by this new device and the utility of the implantation tools and technique.', 'This paper reports a flexible electronics-based epidermal biomicrofluidics technique for clinical continuous blood glucose monitoring , overcoming the drawback of the present wearables , unreliable measurements .', 'This study demonstrates that the BioMonitor 2-AF is a safe and effective tool for continuous cardiac monitoring.', 'BioMonitor effectively detects patients with bradycardia, tachycardia, AF, or asystole.']


Cluster  195
['Resistance to platinum-based chemotherapy frequently poses a serious problem in the treatment of head and neck squamous cell carcinoma .', 'Emesis after the administration of cisplatin is a severe complication , and its treatment is an important problem clinically .', 'In this sense , cisplatin ( CDDP ) is one of the most drugs used in the treatment of OS but drug resistance to CDDP appears as a serious problem in the use of this drug in the treatment of OS .', 'Cisplatin is the most important chemotherapeutic agent involved in treatment of head and neck squamous cell carcinoma ( HNSCC ) , but cisplatin resistance in HNSCC is still a serious problem in clinic .', 'Whereas cisplatin ( CDDP ) has strongly an effectiveness for ovarian cancers , but the drug resistance of cancer cells for CDDP was causing a serious problem .', 'Acquired resistance is a main drawback of using cisplatin in cancer chemotherapy ; however , analogs containing the 1,2-diaminocyclohexane ( DACH ) ligand can overcome this resistance .', 'However , cisplatin-induced nephrotoxicity , which is partly caused by oxidative damage , is a serious problem .', '11 patients receiving chemotherapy including cisplatin (60-80 mg/m2) were included in the study.', 'Cisplatin is a widely used anticancer drug , but its nephrotoxicity is a serious problem .', 'The resistance of head and neck squamous carcinoma cells ( HNSCCs ) to cis-Diamminedichloroplatinum(II ) ( CDDP ) , which is widely used for the treatment of many malignancies , is a serious problem in the clinic .', 'Cisplatin resistance is still a serious problem in the clinic .', 'However , initial resistance to CDDP is a serious problem in treating cancers .']


Cluster  23
['This is a secondary analysis of a randomized-controlled trial comparing robotic and conventional treatment for the UE.', 'Stroke recovery studies have shown the efficacy of bimanual training on upper limb functional recovery and others have shown the efficacy of feedback technology that augments error.', 'These results indicate that robot-assisted hand training was beneficial to improving the hemispatial neglect of elderly person with chronic stroke compared to the conventional treatments.', 'To compare the effect of SMART Arm training, with or without outcome-triggered electrical stimulation to usual therapy, on arm function for stroke survivors with severe upper limb disability undergoing inpatient rehabilitation.', 'Our data suggest that cognitive pc training by using the Erica software may be a useful methodology to increase the post-stroke cognitive recovery.', 'ULCE is an effective device for increasing muscle strength, trunk control and consequently improving the independence of post-stroke subjects in the acute hospital phase.', 'We found that, in our sample, age is significantly associated with the outcome after conventional but not robotic UE rehabilitation.', 'Evaluate the efficacy of MeCFES followed by robotic therapy compared to standard care arm rehabilitation for post-stroke patients.', 'To investigate the effects of the newly developed Spine Balance three-dimensional (3D) system on trunk strength and gait abilities of chronic stroke patients.', 'Despite upper limb rehabilitation is widely investigated in patients with stroke, the effects of scapulohumeral rehabilitation on trunk stabillization are mainly unknown.', 'Our study aimed to investigate the effects of three-dimensional active trunk training exercise on trunk control ability, trunk muscle strength, and balance ability in sub-acute stroke patients.', 'Load addition on NPLL did not alter cardiovascular parameters and gait training provide better gait performance of subacute stroke patients, which indicates this therapy can be considered useful and safe for these patients.', 'To modify and evaluate the efficacy of a computerized visual perception rehabilitation program using interactive motion tracking technology with unilateral neglect after chronic stroke.', 'Robot-assisted therapy (RT) has become a promising stroke rehabilitation intervention.', 'To test the effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke.', 'The purpose of this study was to investigate the effects of robot-assisted therapy on upper-extremity function and the ability to perform activities of daily living (ADL) in patients with stroke-induced hemiplegia.', 'Twenty-six individuals with chronic stroke were randomly assigned to practice an equivalent amount of bimanual reaching either with or without error augmentation.', 'This study aimed at estimating the immediate and retention effects of task specific training and wrist/fingers extension splint on hand joints range of motion and function after stroke.', 'To evaluate if the only robot-assisted end-effector-based gait training can be feasible in chronic stroke subjects in terms of gait recovery.', 'Motor imagery (MI) is a promising therapeutic technique for stroke rehabilitation', 'Verify the effects of ULCE on muscular strength, trunk control and independence of post-stroke subjects in hospital acute phase.', 'The results of this study provide evidence that training using a new multidirectional reach tool is effective for improving balance in individuals with stroke.', "RT may be a useful tool for sub-acute stroke patients' rehabilitation.", 'The results of this study show that a combination of eccentric and task-oriented strength training is an effective and feasible training method to increase function and strength in individuals with chronic stroke.', 'Preliminary findings indicate that a combination of MeCFES and robotic treatment may be more effective than standard care for recovery of the plegic arm in persons > 3 months after stroke.', 'To explore the effects of modified constraint-induced movement therapy (mCIMT), additionally modified by adding trunk restraint (TR), on upper-limb function and activities of daily living (ADLs) in early post-stroke patients.', 'Stroke-induced lower extremity dysfunction has become a severe medical problem nowadays and effective rehabilitation methods are in great demand .']


Cluster  172
['Root rot of poinsettia , caused by Pythium helicoides at high temperatures in hydroponic cultures , has become a serious problem in many parts of the world .', 'Fusarium wilt , a vascular wilt caused by Fusarium oxysporum , has been a serious problem for birdsfoot trefoil ( Lotus corniculatus ) production in parts of New York and Vermont since the 1970s , causing wilt , severe root necrosis , and rapid plant death .', 'This fungus is the causative agent of blackleg disease of brassica oilseeds ; a virulent strain of the pathogen has caused significant rapeseed ( Brassica napus L. , and B. rapa L. ) and canola ( B. napus L. , and B. rapa L. ) losses in Canada , and is also considered a serious agricultural problem worldwide .', 'Fumonisin contamination of maize is considered a serious problem in most maize-growing regions of the world , due to the widespread occurrence of these mycotoxins and their association with toxicosis in livestock and humans .', 'The presence of N. parvum in this subtropical area presents a serious disease problem not only to avocado but also to mango ( Mangifera indica L. ) , which is another susceptible host ( 4 ) .', 'The threat caused by plants fungal and fungal-like pathogens is a serious problem in the organic farming of soft fruits .', 'This fungus is not a serious concern when seeds are dressed with fungicides .', 'Bacterial speck disease is a serious problem worldwide in tomato production areas where moist conditions and cool temperatures occur .', 'The obligate biotrophic , soil-borne fungus Synchytrium endobioticum causes wart disease of potato ( Solanum tuberosum ) , which is a serious problem for crop production in countries with moderate climates .', 'To our knowledge , this is the first report of P. yuccae causing disease in Y. filamentosa in Brazil and it may become a serious problem for the nurseries , due to the severity of the disease and the lack of chemical products to control this pathogen .', "Genomic-scale studies of Moniliophthora perniciosa , the fungus that causes the Witches ' Broom disease in cacao , which is a serious economic concern for South and Central American crops , have identified five members of this family ( termed MpNEP1 - 5 ) .", 'Yield loss due to Cercospora leaf spot ( early and late leaf spots ) is a serious problem in cultivating this crop .', "A severe problem is provided by the so-called opportunistic fungi which become parasitic only after the host 's immunological protection has been impaired by predisposing factors .", 'Plant pathogens are a serious problem for seed export , plant disease control and plant quarantine .', 'This poses a serious concern for growers because no fungicides are labeled for control of Pythium spp . in nutrient solutions for tobacco greenhouse float systems .', 'This quarantine disease is caused by the fungus Colletotrichum kahawae Waller and Bridge , which remains one of the most devastating threats to Coffea arabica production in Africa at high altitude , and its dispersal to Latin America and Asia represents a serious concern .', 'Take-all of wheat ( Triticum aestivum ) , caused by Gaeumannomyces graminis var . tritici , became a serious problem with the widespread adoption of wheat : soybean double-cropping and minimum tillage farming systems in the southeastern United States during the past 30 years .', 'Curvularia eragrostidis yam leaf spot is a serious concern among the northeast Brazilian yam growing areas .', 'The increased resistance to drugs by pathogens is a serious problem , with plants showing to be promising sources for the development of new drugs or the improvement of the effect of existing antimicrobial agents .', 'An undescribed powdery mildew has been reported on L. havardii ( 2 ) , but it has been observed only occasionally on leaves and has not cause a severe problem .', 'To our knowledge , this is the first report of C. pfaffiae causing disease in P. glomerata in Brazil and it may become a serious problem for some medicinal plant growers , due to the severity of the disease and the lack of chemical products for this pathogen .', 'Head blight on wheat , caused by Fusarium spp . , is a serious problem for both farmers and food production due to the concomitant production of highly toxic mycotoxins in infected cereals .', 'Due to its rapid growth and reproduction by asexual spores ( conidia ) , which increases the inoculum pressure , the fungus is a serious problem in different fields of agriculture .', 'Spot blotch , caused by Bipolaris sorokiniana , has emerged as a serious concern for cultivation of wheat in warmer and humid regions of the world , which results in substantial yield losses and descends with quality .']


Cluster  1791
['There is an increasing awareness that infertility in Sub-Saharan Africa constitutes a severe social and public health problem .', "Women's contraceptive choices may change after an induced abortion, due to contraceptive counselling or a behavioural change prompted by the experience", 'This paper examines how people account for health-seeking behaviour regarding infertility in developing countries , where infertility is a serious problem .', 'In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods.', 'Infertility has recently been construed to be a serious problem in sub-Saharan Africa .', 'Despite the accessibility of modern family planning ( FP ) methods , unwanted pregnancies remains a serious problem in Tanzania .', 'The quality of injectable uterotonics in three contrasting districts in Ghana is a serious problem .', 'Analysis of data from the 1988 National Survey of Family Growth -- corrected for the underreporting of abortion -- reveals that contraceptive failure during the first year of use remains a serious problem in the United States , contributing substantially to unintended pregnancy .', 'Whether or not increased prevalence of oral contraceptive use in developing countries is associated with increased morbidity and mortality from circulatory system diseases is a serious concern for health and family planning administrators .']


Cluster  919
['Persistent medically unexplained symptoms ( MUS ) are a serious problem because they are common , difficult to treat effectively , and have a significant impact on both functional outcomes and health-care utilization costs .', 'Although most of these patients do not have a life-threatening condition , the clinician must distinguish between those who require urgent management of a serious problem such as acute coronary syndrome ( ACS ) and those with more benign entities who do not require admission .', 'The median delay from symptom onset to ED arrival was less in cases where a witness first recognized that there was a serious problem than it was when the patient first identified the problem .', 'Symptom monitoring can increase actual treatment-seeking in those with an intention to seek treatment.', 'Acute pain is the most common reason for visits to the emergency department (ED).', 'Although a majority of these patients do not have a life-threatening condition , the clinician must distinguish between those who require urgent treatment of a serious problem and those with more benign entities who do not require admission .', 'We think that symptomatic patients mainly want to know that they do not have a serious problem . Often , they will miss the extra information that they get -- and then they certainly can not benefit from it .', 'While numerous studies have described inadequate treatment of asymptomatic conditions and risk factors , our results suggest similar deficiencies in addressing a serious and eminently treatable symptomatic problem .', 'Urgency were noted in half of the patients , but only a quarter of them consider it a serious problem .']


Cluster  2090
['The study included 91 PwMS, 50 women.', 'Thirty-eight (56%) were female and the mean (SD) age of patients was 18.', 'Out of 100 adult patients, 37% (n\u2009=\u200937) were male and 63% (n\u2009=\u200963) were female.', 'Complete data were available in 46/51 (90%) women.', '486 women were eligible for follow up, of whom 154 agreed to participate.', 'Of 285 patients, 187 were men and 98 were women.', 'Of 250 cases, females (57%) slightly outnumbered males.']


Cluster  1876
['The increasing number of Candida infections , especially those caused by non-C. \xa0 albicans species and resistant strains , is a serious medical problem .', 'Although the candidemia still remains a serious health problem , the study of candidemia in cancer patients is limited .', 'Invasive candidiasis , mainly caused by Candida albicans , is a serious healthcare problem with high mortality rates , particularly in immunocompromised patients .', 'A serious problem for humans is the propensity of Candida albicans to adhere to various surfaces and its ability to form biofilms .', 'Candidaemia still continues to be a serious medical concern and the epidemiology of candidaemia varies according to geographical areas .', 'Oropharyngeal candidiasis is emerging as a serious health problem in the elderly as well as other chronically immunosuppressed patient populations .', 'Candidiasis represents a critical problem to human health and a serious concern worldwide .', 'We conclude that in an institution mainly oriented toward management of cancer and surgical patients , systemic and visceral candidiasis are common and represent a serious problem .', 'Oral candidiasis is a serious problem for immunocompromised patients , especially patients with hematological malignancies .', 'Candida infection has been a serious health problem due to the inappropriate use of antibiotics .', 'Acute disseminated candidiasis is a serious and difficult problem often seen in immunocompromised states .', 'Oral candidiasis represents a serious problem for children with cancer .']


Cluster  408
['There were no significant difference in Revised Foot Function Index scores and total treatment costs between the both groups.', 'There are no statistical differences in the levels of satisfaction in terms of age, type of mastectomy done, coadjutant treatment or existence of complications.', 'In the short- and long-term tests, analyzing the average of the elastomeric measurements, no significant change was observed in any of the parameters analyzed after 15, 30, and 60\xa0minutes.', 'Individuals demonstrated significant improvement in fall rate outcome in both groups with no significant difference.', 'Body weight and segmental body composition showed no significant change in the men or women.', 'Statistical analysis of the results using Mann-Whitney test showed no significant difference in pupillary diameter between two the groups.', 'There was no significant difference between the PE evaluated by Mastora compared with the measurement by CAD (P= 0.', 'There were no differences in QuickDASH scores or change in total score between smokers and non-smokers or between women and men.', 'At baseline, no differences were found between the right and left eyes for any of the main parameters.', 'Both groups significantly improved in all measured physical fitness variables, without any significant changes in body composition.', 'The knee score, function score, and radiographic evaluation were significantly not different between the two groups at final follow-up.', 'The subjects who had and had not purchased a PERS presented no significant differences in terms of time on the ground or consequences.', 'Knowledge of osteoporosis did not change significantly.', 'There were no significant differences found in balance measures, balance confidence, or pain levels for community-dwelling older adults between the Ai Chi and IBAT programs.', 'The attempt at measuring and accounting for the HE showed little difference in HH rates throughout the observation period.', 'No difference was observed in visual analog scale (P > 0.']


Cluster  1497
['There was a statistically significant improvement in the appearance of atrophic scars, with reduction in the scores associated with the clinical evaluation scale for atrophic scarring in all groups, but the improvement was more obvious in group III.', 'This was an intra-individual randomized, observer-blind, controlled study in adults with post-dermatologic surgery scars.', 'To examine the association between healing time and the quality of scar tissue formation.', 'Different therapeutic modalities have been tried for hypertrophic scar treatment.', 'Many products claiming to improve scar appearance are readily available on the Internet', 'This study confirmed that the OIP safely promotes scar healing after minor dermatologic surgery.', 'The authors could objectively demonstrate that epithelialization time is an important factor influencing scar quality.', 'Postoperative scar formation is a serious problem in this surgery .', 'Scar height showed a significant decrease and scar color and pliability showed a significant improvement in group I. No significant changes were detected in group II except in scar pliability.', 'The mean POSAS scores at 9 months post-treatment were significantly lower for tranilast-treated half scars compared with placebo-treated half scars (p < .', 'A prospective, randomized, single-blind intrapatient controlled study was conducted on 9 postoperative scars in the head and neck region.']


Cluster  421
['A drawback of traditional machine learning methods is the relatively little attention given to small sample classification .', 'One shortcoming of querying a search engine to obtain training pairs is it tends to be costly in terms of time and bandwidth', 'Phrase based SMT is also among the top performing approaches available as of today . that the estimates of parameters corresponding to events that occur infrequently in the training data are not reliable', 'While this study introduces statistical measures to evaluate instance quality , it remains vulnerable to data sparseness and has the limitation of considering only one-word terms', 'Within this area , we can distinguish two kinds of phenomena . training with unbalanced data', 'The second issue is that there has been little consistency in the field in the use of cross-validation , the number of L1s , and which L1s are used', 'They also discussed the issue of training with unbalanced data', 'Table 2 gives a breakdown of the average number of annotations for each of the target pairs in the master set . various metrics may be highly correlated with one another , and provide redundant information on performance', 'A similar approach is also developed in there has been little consistency in the field in the use of cross-validation , the number of L1s , and which L1s are used']


Cluster  1494
["Solomon 's approach -LRB- Solomon , 1991 -RRB- uses unannotated corpora , to build lexicons for simple CG . KB annotations are currently present only if there is a YAGO means relation between the mention string and the correct entity", "Solomon 's approach -LRB- Solomon , 1991 -RRB- uses unannotated corpora , to build lexicons for simple CG . KB annotations are currently present only if there is a YAGO means relation between the mention string and the correct entity", 'The primary drawback is that KB annotations are currently present only if there is a YAGO means relation between the mention string and the correct entity', 'The drawback is that the identification of mentions is subject to errors , and thus suffers a lower precision compared to hashtag matching']


Cluster  436
['A major drawback of standard DXA is that the bone mineral density ( BMD ) data can not be used with certainty to predict who will sustain a vertebral fracture .', 'Bone diseases are a serious problem in modern human life .', 'Osteoporosis , mainly characterised by low bone mineral density ( BMD ) , is a serious public health problem .', 'The incidence of CS of bone in Norway is 2.', 'Low bone mineral density ( BMD ) is a silent disease that can lead to osteoporosis and is a serious health problem worldwide .', 'CONTEXT : Low bone mineral density ( BMD ) is a serious public health problem .', 'Bone loss due to trauma and tumors remains a serious clinical concern .', 'In free-text fields , GPs reported most frequently that budgetary restrictions preventing the prescription of appropriate medication represented a severe problem for osteoporosis management .', 'Bone loss is a serious health problem .', 'It is possible to avoid developing a serious osteoporosis and having bone fracture if we realise the problem at the proper time and take the risk factors into consideration .', 'On the other hand , bone destruction was a serious problem among a minority of " risk " individuals after the age of 40 .', 'It is a serious health problem showing the predisposed person with increased bone fracture risk .']


Cluster  551
['The total clinical effective rate of the observation group was higher than that of the control group (P<0.', 'The primary safety endpoint is freedom from system-related complications at 9\xa0months.', 'When divided into two groups based on the median %PV, the clinical features of the expansion group (11≤%PV [range 11% to 36%]; n=24) included a lower incidence of crackles (13% vs.', 'To compare clinical failure of broad vs.', 'The primary cannulation rate was significantly higher in the T group compared with the NT group (88% vs 54%, P\xa0< .', 'Table 1 indicates clinical outcomes at different time points.', 'Some 2507 patients in the RCT were compared with 8485 patients in the non-RCT group.', 'Median progression-free survival (PFS) was 2.', 'The patients were divided into quartiles based on their lowest MAP in the period preceding the peak hsTnT, ranging from a median of 62 in the lowest quartile to 94 in the highest quartile.', 'The number of subjects who achieved a clinical significant improvement was significantly higher in RAGT than in CWT ( p\u2009<\u20090.', 'There were consistent statistical and clinical differences in the mean LATCH scores between the treatment and the control groups ( p < .', 'On side A, 60% of the patients showed excellent improvement while 32% showed excellent response on side B. The mean percentage of improvement was significantly higher on side A than side B (P\xa0=\xa00.']


Cluster  1234
['All high-risk areas where onchocerciasis used to be a serious public health problem have been clearly delineated .', 'The Central African Republic ( CAR ) has a serious onchocerciasis problem .', 'Onchocerciasis ( river blindness ) , caused by the filarial worm species Onchocerca volvulus , is a serious vector-borne neglected tropical disease ( NTD ) of public health and socioeconomic concern .', 'The results indicate that onchocerciasis is a serious public health problem which needs to be controlled .', 'Thus new techniques for the identification of communities in which onchocerciasis is a serious public health problem are required .', 'Onchocerciasis is a serious problem in tropical areas .', 'Onchocerciasis ( river blindness ) is a serious health problem and a severe obstacle to social and economic development , especially in Africa .']


Cluster  1222
["In spanish prisons , tuberculosis is a serious problem of public health and health authorities do n't take it seriously .", 'Tuberculosis currently represents a serious problem in prison populations .', 'Despite being a serious cause of morbidity and mortality among incarcerated populations , many prison systems encounter a variety of challenges that hinder TB control .', 'Tuberculosis in prisons is a serious public health problem .', 'Tuberculosis ( TB ) in prison is a serious public health problem that is fueled by overcrowding , poor nutrition and unsatisfactory medical services .']


Cluster  1095
['Although the incidence of SCLC has been steadily decreasing over time , it remains a serious public health problem given its aggressive clinical behavior and the lack of effective therapies .', 'Thus , CSCs do not represent a fixed target population any longer , and their heterogeneous and dynamic nature present a serious problem in establishing specific therapeutic strategies .', 'Loss of CQ efficacy now poses a severe problem for the prevention and treatment of both diseases .', 'Even if only a small proportion of children with mild CHI suffer persistent negative outcomes , then mild CHI is a serious public health problem .', 'No treatment options have shown proven efficacy , and CHI remains a serious obstetric conundrum .', 'In conclusion , stoppage , a realistic scenario for some complex diseases , can represent a serious and potentially intractable problem for segregation analysis .', 'However , a drawback of total systemic C inhibition , particularly in longterm treatment of chronic disease , is potentiation of infection and immune complex disease due to an inability to opsonize complexes and foreign cells and to lyse pathogens .']


Cluster  739
['Nearly 17 % of subjects considered that they had a serious nose-picking problem .', 'However , only 43.1 % reported they would not tell their parent if they had a serious health problem ; there was an equal split between the confidential services and non-confidential services groups .', 'At least 20 % cited a lack of genetic counseling services for members of their groups as a serious problem and called for greater sensitivity to emotional concerns in the timing and delivery of genetic counseling by professionals .', 'Around 17% of consentable patients did not want to have an external fixator system with recycled components.', 'The most commonly reported reasons for not seeking eye care services were " do not have money for eye checkup " in 30.7 % of the participants followed by " do not have a serious problem " ( 30.0 % ) .']


Cluster  442
['Porcine respiratory disease complex ( PRDC ) is a serious health problem that mainly affects growing and finishing pigs .', 'Porcine circovirus 2 ( PCV2 ) is a serious problem to the swine industry and can lead to significant negative impacts on profitability of pork production .', 'Porcine reproductive and respiratory syndrome virus ( PRRSV ) has caused tremendous economic losses and continues to be a serious problem to the swine industry worldwide .', 'Porcine circovirus type 2 ( PCV2 ) , the causative agent of postweaning multisystemic wasting syndrome ( PMWS ) , is a serious economic problem in the swine industry .', 'Porcine circovirus type 2 ( PCV2 ) is considered to be the primary causative agent of postweaning multisystemic wasting syndrome ( PMWS ) , which has become a serious economic problem for the swine industry worldwide .', 'Modified live vaccines ( MLVs ) have been utilized to combat porcine reproductive and respiratory syndrome ( PRRS ) , which raises a serious concern about the MLV-derived PRRS virus ( PRRSV ) isolates .', 'Porcine circovirus type 2 ( PCV2 ) is a causative agent of porcine circovirus-associated disease ( PCVAD ) , which is a serious problem in the swine industry worldwide .', 'Porcine epidemic diarrhea virus ( PEDV ) infection , which causes acute diarrhea and dehydration in suckling piglets , has become a serious problem for the swine industry of China in recent years .', 'Porcine circovirus type 2 ( PCV2 ) , the primary causative agent of porcine circovirus-associated diseases ( PCVADs ) , is a serious economic problem for the swine industry worldwide .']


Cluster  2080
['Foreign body asphyxia is a serious clinical problem with high morbidity and mortality rates .', 'Foreign body aspiration ( FBA ) is a serious medical problem , also in dental practice .', 'Since aspiration of foreign bodies can be a serious and sometimes fatal problem , early intervention and proper management is vital .', 'Aspiration of foreign bodies is extremely rare in adults , but it may occur during the course of dental treatment and become a serious problem for the patient .', 'Foreign body ingestion and aspiration in children has been a serious problem , occasionally resulting in airway obstruction and death .', 'Foreign body aspiration is a serious health problem in all age groups , and in pregnancy it may cause serious complications for the fetus as well as the pregnant woman .', 'Tracheobronchial foreign body aspiration is a serious medical problem , with clinical manifestations ranging from acute asphyxiation to insidious lung damage , as demonstrated by the three presented cases .', 'FB aspiration is a serious problem .', 'Foreign body aspiration ( FBA ) is a serious medical problem , causing thousands of deaths nationally each year .', 'Foreign Body Aspiration ( FBA ) is a serious problem in children and delays in diagnosis and management can be devastating .', 'Pediatric airway foreign body aspiration is a life-threatening clinical entity in any setting , but it presents unique challenges in resource-limited settings where rigid bronchoscopy is not available .', 'Tracheobronchial foreign body aspiration is a life-threatening emergency.']


Cluster  181
['Deterioration of health check quality due to excessive price competition is a serious concern .', 'While individual accountability is a serious problem for health care providers , corporate liability is a major problem for the institution .', 'The number of negligence claims against physicians and health institutes is increasing and has become a serious financial problem .', 'There is growing concern over a future shortfall in provision of UK otolaryngology consultants', 'Supplies of medicines , devices , and staff a serious concern as Brexit nears .', 'This is a serious problem hampering medical institutions to occupy their segment in the international market .', 'Diagnosis-related negligent adverse events are a serious problem in the healthcare industry .', 'Clinical negligence is a serious problem in the NHS , with claims and costs rising steadily .', 'They had a serious concern for private practitioners or the quality of drugs from pharmacy stores .']


Cluster  1477
['Visceral leishmaniasis ( VL ) is a deadly parasitic diseases caused by Leishmania donovani ; it is a major health problem in many countries .', 'Leishmaniasis is a serious health problem in various endemic areas .', 'Cutaneous leishmaniasis ( CL ) is a serious health problem in Suriname .', 'Evaluation of both human seroprevalence and high incidence of canine leishmaniasis , as well as favorable landscape and climatic conditions of the study area , indicates that high level of clinical awareness need to be employed by physicians , as human and canine visceral leishmaniasis constitutes a serious public health concern .', 'Visceral leishmaniasis ( VL ) is an important neglected disease caused by a protozoan parasite , and represents a serious public health problem in many parts of the world .', 'Dogs are the main reservoir for visceral leishmaniasis in urban areas , which has become a serious public health concern in Brazil .', 'Human visceral leishmaniasis is a serious public health problem in endemic countries because of its high potential lethality , particularly in children .', 'Visceral leishmaniosis ( VL ) remains a serious public health problem in Brazil .', 'In Brazil , visceral leishmaniasis ( VL ) is a serious public health problem because of its magnitude , geographical expansion and potential harms caused by illnesses , including death .', 'Human immunodeficiency virus ( HIV ) coinfection with Leishmania infantum or Leishmania donovani , the agents of visceral leishmaniasis ( or kala-azar ) , has become a fatal public health problem in the tropics where kala-azar is endemic .', 'American tegumentary leishmaniasis ( ATL ) is a widespread anthropozoonosis caused by protozoa of the genus Leishmania and is considered a serious public health problem .', 'Leishmaniasis from Leishmania infantum is a parasitary zoonotic disease and a serious problem to public health .', 'In Peru , leishmaniasis is a metaxenic disease that represents a serious public health problem , due to its wide distribution and the number of people in danger of contracting the disease , being the vulnerable population mainly those with low economic resources .', 'The RESULTS suggest that CVL is widely distributed in Natal , may be increasingly urbanizing and will spread through neighborhoods but not endemic , resulting in a serious public health problem , emphasizing the need for epidemiological studies to a greater understanding of the distribution of canine leishmaniasis in these specific areas and contribute proactively to the public health policies .', 'Leishmaniosis is currently considered a serious public health problem and it is listed as a neglected tropical disease by World Health Organization ( WHO ) .', 'Leishmaniosis , caused by intracellular parasites of the genus Leishmania , has become a serious public health problem around the world , and for which there are currently extensive limitations .', 'Visceral leishmaniasis is a serious public health problem on the Indian subcontinent , causing high morbidity and mortality .', 'Visceral leishmaniasis remains a serious public health problem in developing countries .', 'Leishmaniasis is considered a serious public health problem in several regions in Brazil and worldwide .', 'Leishmaniasis is a serious problem that affects mostly poor countries .', 'American tegumentary leishmaniasis is a serious Brazilian public health problem .', 'Leishmaniasis is a serious health problem in several parts of the world , and localized cutaneous leishmaniasis ( LCL ) is the most frequent presentation of the tegumentary form of this disease cluster .', 'The leishmaniasis and Chagas diseases constitute a serious public health problem worldwide with few and ineffective treatment options .', 'Epidemics of fatal visceral leishmaniasis caused by the intracellular protozoan Leishmania are a severe public health problem in tropical and subtropical regions of the world .', 'Canine and human zoonotic leishmaniasis caused by Leishmania infantum , which is transmitted by the bite of infected phlebotomine sand flies , is a serious public health problem in the Mediterranean basin and Latin America .', 'Visceral Leishmaniasis or Kala-azar ( KA ) is a serious health concern in India .', 'Canine leishmaniasis ( CanL ) due to Leishmania infantum is a disease of great veterinary importance and a serious public health problem .', 'Leishmaniasis is a serious health problem in some parts of the world .', 'Leishmaniasis remains a serious public health problem in several parts of the developing world .', 'Cutaneous leishmaniasis ( CL ) is a serious public health problem in many tropical and subtropical regions of the world .', 'Leishmaniasis , a category 1 disease , has remained neglected for decades , and therefore , has developed into a severe health problem worldwide .', 'Leishmaniasis causes significant morbidity and mortality and thus constitutes a serious public health problem .', 'Cutaneous Leishmaniasis is a serious public health problem , typically affecting poor populations with limited access to health care .', 'Zoonotic visceral leishmaniasis ( ZVL ) is a serious public health problem in several Brazilian cities .', 'Visceral Leishmaniasis ( VL ) is an infectious disease which constitutes a serious public health problem , integrating the list of neglected tropical diseases .', 'In Mexico cutaneous leishmaniasis ( CL ) occurs in 17 of 32 States , and is a serious public health problem .', 'Visceral leishmaniasis ( VL ) , a deadly parasitic disease , is a major public health concern globally .', 'Leishmania major is the main causal agent of cutaneous leishmaniasis ( CL ) that remains a serious public health concern in many tropical and subtropical countries .', 'Phlebotomine sand flies are vectors of Leishmania parasites causing different clinical forms of leishmaniases that represent a serious emerging public health problem worldwide .']


Cluster  1863
['patients were more willing to have serious conversations with roommates whose surgical status was dissimilar (postoperative) and whose type of surgery was similar (TKA).', 'TKA has proved to significantly decrease the preoperative levels of anxiety and depression.', 'We recommend implementation of an assignment policy that patients prior to TKA should be assigned into a postoperative roommate undergoing TKA as well.', 'We assessed early post-operative outcomes in a cohort of 520 TKA patients.', 'The first 50TKAs operated on at an academic department using patient-specific templates (PSTs) were scheduled to enter the study.']


Cluster  1779
['Nineteen children were enrolled.', 'Infants received 19.', 'We recruited 19 AR without previous experience.', 'Eighteen volunteers were enrolled.']


Cluster  1389
['In the first study 19 patients presented at delivery with preeclampsia.', 'Preeclampsia is a serious medical problem affecting the mother and her child and influences their health not only during the pregnancy , but also many years after .', 'Hypertension during pregnancy is a serious obstetrical problem , and the pathophysiology of pre-eclampsia is unclear .', 'Hypertension is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality.', 'Semaphorin 3F might represent a predictive biomarker of preeclampsia.', 'Preeclampsia is a systemic disorder, affecting 2-10% of pregnancies, characterized by a deregulated pro- and anti-angiogenic balance.']


Cluster  363
['This multicenter, controlled, single-blind study (NCT01832090) included 114 subjects randomized 3:1 to CaHA treatment and untreated control groups.', 'AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF.', 'From May 2013 to April 2015, a total of 864 patients with ACS were divided to high glycemic variability group (H group) (n=285) and low glycemic variability group (L group) (n=579).', 'Patients randomized to ACR reported a significantly higher OSS at 6 months than those randomized to HD.', 'This prospective and observational study was conducted of 169 aSAH patients.', 'Patients with the ACD had less symptomatic reherniations, reoperations, and complications and gained 0.', 'Ninety male patients, ASA II-III, 50-75 years old were included in this prospective and randomized double-blind study.', 'The single-blind clinical trial was performed on 70 patients with ACS.', '2661 patient with ACS were enrolled and followed up during median 31.', 'Over 1 year, the number of patients with AC increased from 47 to 56%, and CaSc from 355 (interquartile range [IQR] 75-792) to 529 (IQR 185-1632).', 'Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p=0.', 'We prospectively recruited 175 controls and 175 aSAH patients.', 'Ten control patients and 24 SAH patients were prospectively enrolled in this study.']


Cluster  1178
['Hemostasis time for the first bleeding episode during ESD was 73.', 'Results suggest that developmental haemostatic changes will have little impact on response to DE.', 'The wheal-and-flare peaked at 30 min; after 8 h, no clinical signs were visible.', 'For many years a serious unresolved problem was that the clotting time was normal even in severe thrombocytopenia .', 'Haemostasis was permanent in all cases.']


Cluster  82
['Participants for this study will be selected based on the following inclusion criteria:Participants are randomly allocated to the placebo or yellow-yeast-rice-treated group.', 'A total of 98 people age-matched older adults (65\xa0years) with elevated blood lipids were enrolled to receive 12-week supplementation of a Citrus bergamia extracts-based formulation (CitriCholess)(n\u2009=\u200948) and placebo (n\u2009=\u200950).', 'According to the findings of this study, supplementation with C. vulgaris with a dosage of 1500\xa0mg/day for 8\xa0weeks, does not improve the anthropometric measurements, glycemic status, and lipid profile as well.', 'This is the first human intervention study to investigate the cholesterol-lowering effects and safety of yellow yeast rice in adults with mild to moderate hypercholesterolemia.', 'Barley kernel based products have been shown to induce benefits on blood glucose regulation, cardio-metabolic risk markers and appetite regulating hormones in a time perspective of 11-16\xa0h after intake.', 'The monthly average consumption of aminoglycosides and cefepime had a statistically significant increase (p<0.', 'The improvements in cardiometabolic risk markers and cognitive performance after the berry beverage suggest preventive potential of berries with respect to type 2 diabetes, cardiovascular disease, and associated cognitive decline.', 'After 3 months supplementation period, body weight, body mass index, and fasting blood glucose reduced significantly in the Momordica charantia group.', 'Forty healthy subjects between 50-70 years old were provided a berry beverage based on a mixture of berries (150g blueberries, 50g blackcurrant, 50g elderberry, 50g lingonberries, 50g strawberry, and 100g tomatoes) or a control beverage, daily during 5 weeks in a randomized crossover design.', 'Barley kernel bread was included in the normal diet of 21 healthy subjects in two 4-day intervention periods; with (BB-pro) or without (BB) dietary supplement with a combination of probiotics (Bifidobacterium animalis DN-173 010, Lactobacillus reuteri DSM 17938, and Lactobacillus plantarum 299v).', 'After 6 months of supplementation, paired-sample t test showed that CD4 cell count did not significantly differ from baseline for all 3 groups.', 'This study investigated the role of blueberries in modulating immune cell levels and attenuating circulatory and monocyte inflammation and oxidative stress in metabolic syndrome (MetS) subjects.', 'The MED was increased in the subjects consuming almonds compared to the control group consuming pretzels.', 'We found that milk yield increased in cows receiving the 6% (w/w) moringa supplement compared with that of the control.', 'Recent experiments suggest that Citrus bergamia extracts could benefit people with dyslipidemia and obesity but this needs to be further validated.']


Cluster  2117
['Three patients in the PSA group developed an SSI compared to 8 in the PLC group at 30\xa0days (8 vs 30%, p\xa0=\xa00.', 'This prospective observational study compares the accuracy of the SSS with that of the SJSA in the same patient population.', 'To determine if underreporting of secondary endpoints in randomized controlled trials occurs, using surgical site infection (SSI) as an example.', 'Secondary endpoint assessment of SSI in randomized trials was associated with significantly reduced rigor and subsequent detection rates compared with assessment as a primary endpoint.', 'A total of 534 patients were randomized; 31 (5·8 per cent) developed an SSI.', 'SSI is a commonly measured endpoint in surgical trials and can act as a proxy marker for primary and secondary endpoint assessments across trials in a range of medical specialties.', 'In 2 prospective centers for observational study, serum concentrations of SUA were measured on admission in the serum of 710 consecutive patients with AIS.']


Cluster  979
['Analysis included 42 patients with left-sided and 52 with right-sided resections.', 'This study shows that for patients who do not progress to prolonged ileus, those with left-sided resections experience faster return of bowel function when compared with those having right-sided resections.', 'An open, prospective intrapatient left-to-right study was designed.', 'A prospective multicenter study including 36 physicians (18 left-handed and 18 right-handed) and 7200 patients was conducted in 6 medical centers.']


Cluster  468
['The problem with most studies of empathy in medicine is that empathy is poorly defined and tends to overlap with other related things , such as emotional contagion , sympathy , or a caring personality in general .', 'Empathy is a professional value difficult to teach and challenging for beginning nursing students to grasp', 'Nurse managers encounter a wide range of ethical problems related to patients, staff, the organisation and themselves', 'The attitudes towards learning Professional Ethics among students of the Physiotherapy Degree at the university is favourable, although it varies depending on the academic year, with the students in the academic year in which Ethics is taught (i.e. second year students) being the ones with better attitudes.', 'The aim of this paper was to investigate ethical erosion among medical trainees as a serious universal problem , and to urge the authorities to take urgent preventive and corrective action .', 'Medical students scored significantly higher than nursing ones on values related to dominance over others and personal success.', 'The purpose of this study was to verify if and to what extent there were divergences in the personal values profile between medical and nursing students at the beginning of their education and training.', 'Nurse managers are responsible for solving work-related ethical problems to promote a positive ethical culture in healthcare organizations', 'Although the literature is replete with information about grades, there is a lack of empirical evidence about the meaning of grades to nursing students', "Schwartz's Theory of Basic Human Values may be a valuable theoretical framework for interprofessional education to promote a common reflection on personal values held by medical and nursing students since the early years of study.", 'Collaboration in healthcare is essential but differences in personal values can be a potential source of disagreements between physicians and nurses.']


Cluster  2183
['While the present study examined possible effects of depression, anxiety and the ability to identify and describe feelings, a larger sample is needed in order to optimally address their potential moderating effect.', 'The aim of this study was to investigate whether monitoring symptoms of depression and anxiety using an app increased treatment-seeking.', 'However , a problem with the research on the significance of anxiety in depressed patients is that anxiety has been characterized in different ways .', 'This study found correlation between symptom burden and hope was not clinically relevant but was so for depression.', 'The aim of the study was to analyze the role of catastrophizing on the effect of depression on pain and functional ability.', 'A sample of 400 subjects that have a mild to severe depressive episode (Becks Depression Inventory - II and Hamilton Depression Scale) will be used.', 'The participants were 233 adult patients diagnosed with depression and/or anxiety disorders.', 'Depressive symptoms were observed in 232 of the 763 participants (30.']


Cluster  2229
['Despite that some approved drugs and genetically engineered vaccines against hepatitis B virus ( HBV ) are available for HBV patients , HBV infection is still a severe public health problem in the world .', 'Hepatitis B virus ( HBV ) infection is still a serious worldwide problem , and vaccination is the most effective strategy for primary prevention of the infection .', 'Chronic hepatitis B continues to be a serious problem worldwide .', 'Chronic hepatitis B virus ( HBV ) infection remains a serious global health concern .', 'Chronic hepatitis B virus infection is a serious problem because of its worldwide distribution and possible adverse chronic sequelae , such as cirrhosis and hepatocellular carcinoma .', 'Hepatitis B virus ( HBV ) continues to be a serious worldwide health problem despite the use of protective HBV vaccines and therapeutic regimens against chronic HBV infection .', 'Chronic hepatitis B is a serious global health problem .', 'Chronic hepatitis B virus ( HBV ) infection is a serious problem owing to its worldwide distribution and potential adverse sequelae that include cirrhosis and/or hepatocellular carcinoma .', 'Accelerated vaccination schedule using combined hepatitis A and B vaccine may be beneficial for HBV seroprotection among hemodialysis patients.', 'Hepatitis B virus ( HBV ) is a serious global health problem , and HBV genotype is an important determinant of disease progression and treatment outcome .', 'Currently , chronic hepatitis B virus ( HBV ) infection remains a serious public health problem in the world .', 'Chronic hepatitis B virus ( HBV ) infection is a serious problem because of its worldwide distribution and possible adverse sequelae , such as cirrhosis and hepatocellular carcinoma .', 'Chronic hepatitis B is one of the most frequent infectious disease in the world and represents a serious problem of public health', 'At Sahlgren Hospital , Göteborg , hepatitis B has been a serious problem for several years among the personnel in the hemodialysis and renal transplantation wards as well as in the chemical laboratories .', 'Chronic hepatitis B virus ( HBV ) infection is a serious clinical problem because of its worldwide distribution and potential adverse sequelae .', 'Chronic hepatitis B virus ( HBV ) infection affects approximately 240 million people worldwide and remains a serious public health concern because its complete cure is impossible with current treatments .', 'HBV infection is a serious public health problem worldwide , which can contribute to the incidence of chronic hepatitis B ( CHB ) , cirrhosis , and hepatocellular carcinoma ( HCC ) .', 'Chronic hepatitis B is a serious long-term problem for children surviving malignancy .', 'Chronic hepatitis B is a serious public health concern .', 'Hepatitis B virus ( HBV ) infection , a cause of hepatocellular carcinoma ( HCC ) , remains a serious global health concern .', 'This article is relevant in that it outlines the significant achievements of a dedicated group of individuals to solve a serious public health problem , that of eliminating hepatitis B as a risk for our children .', 'While an effective vaccine against hepatitis B virus ( HBV ) has long been available , chronic HBV infection remains a severe global public health concern .', 'Hepatitis B virus remains a serious problem , particularly for patients with end-stage renal disease on maintenance hemodialysis .', 'Chronic hepatitis B ( CHB ) remains a serious clinical problem worldwide .', 'Hepatitis B virus ( HBV ) infection is a serious public health problem leading to cirrhosis and hepatocellular carcinoma .', 'Hepatitis B virus ( HBV ) infection remains a serious global health problem despite the availability of a highly effective vaccine .', 'Chronic hepatitis B virus ( HBV ) infection is a serious public health problem and may progress to liver fibrosis , cirrhosis and hepatocellular carcinoma .', 'Despite the introduction of universal vaccination against hepatitis B in over 100 countries , persistent HBV infection is still a serious problem worldwide , causing an estimated annual death rate of one million .', 'Chronic hepatitis B virus ( HBV ) infection causes liver cirrhosis and hepatocellular carcinoma and remains a serious health problem worldwide .', 'Though the global epidemiology of hepatitis B virus infection has declined due to effective immunization , chronic hepatitis B ( CHB ) remains a serious public health problem and there is still a need for more treatment options that are efficient , safe and simple for different kinds of CHB patients .']


Cluster  114
['The purpose of this study was to assess the feasibility of administering a low dose of contrast medium via venous regional limb perfusion.', 'ASL perfusion imaging is a contrast agent-free method suitable for assessment of reversible perfusion changes during or immediately after MA.', 'The main limitation of perfusion assessment with indocyanine green fluorescence angiography during colorectal surgery is that the surgeon assesses the quality of perfusion subjectively .', 'Non-invasive assessment of FR using PPV<sub>CNAP</sub> seems to be interchangeable with PPV<sub>PiCCO</sub> in patients undergoing major open abdominal surgery.', 'Antrum microcirculation (mean ± SD) was lower in the EA group at baseline (1,150 ± 189 laser speckle perfusion units [LSPU] vs LA group: 1,265 ± 163 LSPU; p\xa0= 0.', 'Contrast-enhanced CT scans had a moderate diagnostic accuracy for EVs in liver cirrhosis.', 'The simultaneous monitoring of splanchnic near-infrared spectroscopy and echocardiography could identify low mesenteric perfusion in the presence of hemodynamic ductus arteriosus.', 'We showed for the first time that the method is feasible to monitor renal tissue oxygenation at the level of microcirculation non-invasively and reproducibly during PNx.', 'This is the first report to show a relationship between liver function and fluorescent signals on the liver surface after intravenous ICG injection.']


Cluster  1465
['The single-blind method was used to conduct a prospective controlled study on 120 patients with geotropic HC-BPPV from May 2014 to May 2017.', 'Forty-eight patients with HBT were compared with 51 controls matched for gender, age, and BMI for MPV in a cross-sectional study.', 'Forty-three EHPVO patients (30 with and 13 without OAT) and 43 cirrhotic patients were included for a total of 471 VBL sessions.', "The prevalence of EBV was described in various HL and non-HL's and was found similar to that of Western literature.", 'The higher MPV in patients with HBT could indicate platelet activation, and this may represent a dilemma.']


Cluster  406
['Hospital-acquired COVID-19 represents a serious public health issue , which is a problem that could create reluctance of patients to seek hospital treatment for fear of becoming infected .', 'Fatality was detected in 40% (318 of 799) patients with COVID-19.', 'We report a severe case of COVID-19 in a patient with chronic lymphocytic leukemia and describe primarily the clinical presentation and the challenges encountered in the COVID-19 diagnosis , treatment , and specimens sampling pitfalls .', 'Observational cohort study enrolling patients admitted due to COVID-19.', 'On admission, the incidences of MN and the RMN in COVID-19 patients were 17.', 'The recent coronavirus disease 2019 (CO-VID-19) pandemic has placed worldwide health systems and hospitals under pressure, and so are the renal care models', 'Potential drug-disease interactions affecting patients with COVID-19 and comorbid cardiovascular diseases are also becoming a serious concern .', 'Patients at greatest risk of severe clinical conditions from coronavirus disease 2019 (COVID-19) and death are elderly and comorbid patients', 'In this review , we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic , including the use of telemedicine , how a severe reduction in operative volume affected our programme , the process of redeployment of staff , repurposing of residents into specific task teams , the creation of operation room intensive care units , and the challenges that we faced in this process .', 'In this study, 318 fatality was seen in 799 patients with COVID-19.', 'There is a serious concern over the variation of case fatality of COVID-19 patients that reflects the preparedness of the medical care system in response to the surge of pneumonia patients .', 'A total of 11,894 prehospital records were included, of which 481 had a primary hospital diagnosis code related to-, or positive test results for Covid-19.', 'In this review , we review the cardiovascular manifestations of COVID-19 and describe our system-wide adaptations to the pandemic , including the use of telemedicine , how a severe reduction in operative volume affected our program , the process of redeployment of staff , repurposing of residents into specific task teams , the creation of operation room intensive care units , and the challenges that we faced in this process .', 'Main aim of this study was to investigate the impact of diabetes and cardiovascular disease (CVD) on disease prognosis and severe health outcomes among patients with COVID-19.', 'Forty-seven COVID-19 patients were recruited for this prospective study.', 'While prehospital suspicion was strongly indicative of hospital-confirmed Covid-19, based on the sensitivity identified in this study, prehospital suspicion should not be relied upon as a single factor to rule out the need for isolation precautions.', 'Since the COVID-19 pandemic became a serious health concern globally , patients with chronic diseases have required close attention with regard to general risks and individual treatment .']


Cluster  341
['In this study, 270 pregnant women were assigned to the taller (Group T) or shorter group (Group S) based on their heights.', 'Sixty parturient women were allocated into 2 groups in this prospective study.', 'We analysed data on 4775 mothers and 4233 children (median age of 6.', 'In a randomised control trial, 161 primiparous women were randomly assigned to a smartphone website group (n=81) or a leaflet group (n=80).', 'Postterm and late-term pregnancies still remain a serious health problem , and underlying exact mechanisms are not fully elucidated .', "Mothers' postpartum concerns were compared in two clinical trials: 1997 (high-risk pregnancy) and 2015 (first-time mothers).", 'This is a double-blind clinical trial study performed on 140 primiparous women.', "To determine if U.S. women's postpartum concerns have changed over time.", 'Postpartum maternal morbidity is a serious public health problem .', 'A quasi-experimental study design was used, and study participants comprised 168 expectant mothers, who were purposely selected and assigned to randomised control and intervention groups.', 'A pilot randomised controlled trial was conducted with 46 pregnant women.', "This prospective, observational study commenced when participants were <20 weeks' gestation, continuing until the end of their pregnancy.", 'Seventy-five pregnant women (mean age 31.', 'A sub-sample of women whose infants were under one year who had participated in the ELSIPS RCT which randomised women to receive either standard care or the services of a Pregnancy Outreach Worker (POW), and who were contactable, were eligible to participate in the follow up.']


Cluster  917
['This paper presents the rational and background for developing the intervention.', 'Our retrospective observational study was conducted on a population of 13,016 students, aged between 16 and 19 years, in different Italian regions.', 'Our study demonstrated that protective behavior must be implemented in people living in Trieste.', 'More evidently in this pilot study , there was a serious problem in the organizational dimension , in specific , in Managerial Support . Just as it appears , the study sample is perceived " less healthy " , both physically and mentally , than the Italian normative sample .', '92 subjects were recruited from a rural Sicilian village (Resuttano, Sicily, Italy).', 'The situation of this conditions that we find in other countries and in Italy would resulting a serious problem . If not overcome by positive judgment in the orientation .']


Cluster  632
['To test whether material debunking widely shared myths influences knowledge and the intention to provide adequate help to others, and if such information reduces reading enjoyment.', 'All participants, non-donors, were randomly assigned to one of four experimental conditions of a 2 (type of communication: persuasive vs binding) × 2 (source credibility: low vs high) factorial design.', "While all participants acknowledged and appreciated the government authorities ' efforts in disseminating and educating the masses on such a large scale using different modes of message delivery , all showed a serious concern as to whether they will be able to continue coping with the ongoing situation .", 'While ignorance among individuals , as well as experts and organizations , is a serious social problem with potentially deadly consequences , ignorance remains relatively unrecognized since it has major liabilities as a marketable issue .', 'All the media coverage conveyed our intended message that food insecurity is a serious population health problem , confirming that message framing , personal narratives and visual imagery are important in persuading media outlets to carry stories about poverty as a determinant of population health .', "Taken together, it appears as though ensuring message content is targeted to the specific population's beliefs and motives is of importance when developing behavioral change intervention material.", 'Our study aims to test the effectiveness of binding communication based interventions (vs classical persuasive communication based ones) inciting non-donors to act in favour of blood donation.', "We shall summarize Perrault 's theory briefly as it relates to informing and belief . we only cover about half of the utterances"]


Cluster  1512
['Decannulations after PDT are easily done.', 'A drawback of the recent CBHIR framework is that a query ROI needs to be manually selected from a WSI .', 'The main limitation of querying CGI scripts is that if the web site being queried is modified by its creators , slight modifications will have to be made to the query generator to accommodate those changes', 'Self-collection was considered easy in 99.', 'The Read Code search supported practices to populate their registers and was quick to run and review, making it a viable choice to support register revalidation.']


Cluster  1744
['The development of insecticide resistance is a serious problem in controlling of this pest .', 'A serious shortcoming of many insecticides is that they can kill non-target species .', 'Development of insecticide resistance has been a serious concern worldwide , whose mechanisms have been attributed to evolutionary changes in pest insect genomes such as alteration of drug target sites , up-regulation of degrading enzymes , and enhancement of drug excretion .', 'Its increasing resistance to insecticides constitutes a serious problem , and understanding the mechanisms involved is therefore of great interest .', 'Insecticide resistance is a serious economic problem that jeopardizes sustainability of chemical control of herbivorous insects and related arthropods .', 'There are a number of insecticides used for their management , but development of resistance is a serious problem .', 'Insecticide resistance has become a serious concern in controlling the insect vectors of public health importance .', 'Cross-resistance between insecticides , especially from different groups , can be extremely unpredictable , and it has been a serious concern in pest control .', 'Insecticide resistance is a serious problem for vector control programmes worldwide .', 'These results indicate that , although resistance is a serious problem in this species , satisfactory control should be possible by selection of an appropriate insecticide .', 'Pesticide resistance is a serious problem that poses a major challenge to pest control .', 'Pesticide resistance poses a serious problem for worldwide mosquito control programs .', 'Insecticide resistance has recently become a serious problem in the agricultural field .', 'Overuse of broad-spectrum insecticides for diamondback moth control is a serious problem and has obscured the contributions of indigenous parasitoids .', 'Insecticide resistance is a serious problem that negatively impacts food production , food storage , human health , and the environment .', 'However , the harmful effects of insecticides against beneficial Insects continuous to be a serious problem .']


Cluster  335
["Assay sensitivity was demonstrated based on mean baseline- and placebo-corrected QT interval using Fridericia's formula (ΔΔQTcF) >\xa05\xa0ms following moxifloxacin administration (p\xa0<\xa00.", 'The complete response (CR) rate in the desmopressin plus suoquan group (37.', 'The results revealed significant differences between the study periods for Cmax, AUC0-t and AUC0-∞ values corresponding to ATX and its metabolite.', 'To assess whether the timing of administration of prednisolone affects the diurnal rhythm of Ntx in urine.', 'Compared to run in and morning prednisolone treatment urine Ntx levels were suppressed from 24.', 'FVX had a modest effect on the pharmacokinetics of ATX and 4-hydroxyatomoxetine-O-glucuronide.']


Cluster  1575
['Tibiotarsal rotation in ostrich chicks is a serious problem that accounts for considerable financial loss to ostrich farmers .', 'Feather pecking is a serious problem in poultry housing , as it may lead to feather damage , injuries and even mortality .', 'Poor nutrition is a serious problem in captive psittacine birds .', 'Parasitical invasions constitute a serious veterinary-economic problem in pheasant breeding .', 'Importantly , feces from birds contain intestinal , urinary , and reproductive-associated microbiota thus posing a serious problem to study one anatomical region at a time .', 'Coccidiosis caused by Eimeria spp . is a common parasitic disease posing a serious problem in pigeon keeping .', 'However , pecking the feathers of conspecifics remains a serious problem that negatively affects the welfare of the birds as well as the economy of a farm .', 'Land snails are an important calcium source for many passerines and human-induced changes in snail populations may pose a severe problem for breeding birds .', "Foot pad dermatitis ( FPD ) is a serious problem of the modern poultry industry , negatively affecting birds ' welfare and health status , walking and feeding activity , growth performance , carcass quality , and economic performance of meat production .", 'This bird is considered an important vector of pathogens to man and domestic animals , and today it represents a serious hygienic-sanitary problem .', 'ND is a serious problem in developing countries , causing huge loss in the poultry industry .']


Cluster  2135
['Spinal cord injuries are still a serious problem for regenerative medicine .', 'Spinal cord injury ( SCI ) is a serious medical problem , leading to lifelong disability and increasing the health burden worldwide .', 'Spinal cord injury is a serious global public health problem that often leaves patients with devastating permanent disabilities .', 'Spinal cord injury ( SCI ) is a devastating problem of health .', 'Spinal cord injury ( SCI ) represents a severe health problem worldwide usually associated with severe disability and reduced quality of life .', 'Spinal cord injury ( SCI ) is a serious clinical problem for which no suitable therapeutic strategies have been worked out so far .', 'Spinal cord injury is a serious problem with a high rate of morbidity and mortality for all persons , especially young people ( 15 - 25 \xa0 years old ) .', 'Spinal cord injury is a devastating health problem that affects thousands of individuals each year .', 'Traumatic spinal cord injury remains a serious public health and social problem .', 'Spinal cord injury is a serious disabling disease caused by a series of internal and external factors in the field of orthopaedics and neuroscience , which is a big problem for doctors all over the world .', 'Traumatic spinal cord injury ( TSCI ) is a devastating problem typically associated with multi-organ disorders .', 'Spinal cord injury ( SCI ) is a serious clinical problem that causes lifetime disabilities to victims and inflicting huge social burden on our society .', 'Spinal cord injury ( SCI ) is a serious medical problem with high mortality and disability rates .', 'Spinal cord injuries ( SCI ) have been reckoned for many years a serious clinical problem .', 'Affecting young people during the most productive period of their lives , spinal cord injury ( SCI ) is a devastating problem for modern society .']


Cluster  1815
['It was hypothesized that thoracic KT could significantly change pulmonary function and functional capacity in patients with COPD.', 'Patients had lower lung function values than controls: forced expiratory volume in 1 s (FEV<Sub>1</Sub>) (median 97.', 'To examine short-term effects of elastic chest wall restriction on pulmonary function in children with CF.', 'Fourteen patients with moderate chronic obstructive pulmonary disease were randomly assigned to either the respiratory and core-postural stabilisation or abdominal breathing group.', 'Ventilation inhomogeneity as measured by SIII<sub>N2</sub> and SIII<sub>DTG</sub> was increased in patients with COPD compared with healthy subjects (P\xa0< .', 'Our novel results suggest that the effects of respiratory and core-postural stabilisation breathing on diaphragmatic movement and pulmonary function were superior to those of abdominal breathing in patients with chronic obstructive pulmonary disease.', 'The EasyOne Pro (NDD) and Exhalyzer D (EM) were randomly applied in 85 adults (34 with CF) and 97 children (47 with CF and normal forced expiratory volume in one second).', 'This randomized controlled clinical trial demonstrates that IMT attenuates the respiratory muscle oxygen demand-delivery mismatch during respiratory fatigue in patients with chronic HF.', 'SIII<sub>N2</sub> and SIII<sub>DTG</sub>, two fast and clinically applicable measures of small airway disease, reflect different physiological and clinical aspects of COPD, largely independent of spirometry.', 'Compared to placebo plus montelukast, PCKL and montelukast revealed greater efficacy in lung function, measured by FEV1 (P\u200a<.', 'HFCWO affects breathing pattern and SpO2 but not ventilator settings, whereas CCPT maintains a steadier condition.', 'Thirty adult CF-patients underwent pre-flight evaluation with spirometry, arterial oxygen tension (PaO<sub>2</sub>), pulse oximetry (SpO<sub>2</sub>) and cardiopulmonary exercise testing (CPET) at sea level (SL).']


Cluster  1671
['Aortic enlargement after hemiarch replacement ( HAR ) for acute type A aortic dissection ( AAAD ) is a serious problem .', 'Ascending aortic dilatation with stenotic BAV progresses after AVR at a maximum rate of 1.', 'It is generally known that Stanford type A aortic dissection has up to now been a serious problem of cardiothoracic surgery .', 'Aortic elongation has not yet been considered as a potential risk factor for Stanford type B dissection (TBD).', 'Brachiocephalic branch re-entry in patients with A-AAD is related to a patent false lumen in the aortic arch early after ascending aortic replacement and is a risk factor for late aortic arch enlargement.', 'Acute aortic dissection is no longer a catastrophic event because this problem can be rapidly diagnosed with current medical technology , and therefore promptly treated with medication and surgery .', 'In a collective of 52 patients with aortic coarctation 25 patients received stenting and/or balloon angioplasty, and 20 patients underwent MRI before and after an interventional treatment procedure.', 'Quality of life in patients late after aortic coarctation repair is fairly good compared with healthy controls.', 'The combination of coarctation of the aorta in the presence of severe aortic insufficiency poses a serious clinical problem .']


Cluster  354
['The goal of this project was to establish and evaluate a benchmarking system for autologous PBSC collection.', 'Our study shows that software version is comparable to the paper version.', 'In summary , the program has the following strengths : ( 1 ) it is generally applicable to circumstances in which different populations of elementary events occur concurrently , a drawback of methods that employ matched filtering techniques , ( 2 ) it is relatively insensitive to drifts in baseline , and ( 3 ) it generates user-accessible arrays of the timing , amplitude and kinetic parameters of the detected events , making customized statistical analysis of event characteristics easily executable .', 'Workflow management is a serious concern in any organisation and a clinical laboratory is a particularly good example of where the information system ( LIS ) needs to be well integrated with the physical system comprising the doctors , technicians and the machines necessary to analyse and report on samples .', 'The reliability of selecting the traces was assessed by reading the same traces at an interval of 30 days.', 'NPL will have a number of modern flow of control facilities -LRB- for example , FOR and WHILE loops -RRB- . requiring manually sense-tagged data', 'We observed that the implementation of an NIV management protocol that integrates initiation and discontinuation criteria for NIV is feasible.', 'As a main drawback of standard monitoring procedures is linked to the computational costs , two remedies are jointly considered : first , an order-reduction of the numerical model used to track the structural dynamics , enforced with proper orthogonal decomposition ; and , second , an improved particle filter , which features an extended Kalman updating of each evolving particle before the resampling stage .', 'The use of this monitoring matrix is simple and inexpensive.', 'The model-based system function approach addresses a major drawback of the measurement-based procedure , namely , the long acquisition time .', 'The reproducibility of the walking variables under ST and DT conditions was excellent with ICC values of .', 'The main challenge for an experiment setup as described here is the considerable delay between user input and wizard response', 'This report is the first to show AR expression in PCMC.', 'Third , we wanted to investigate the performances of different algorithms in the online and offline experiment settings . they are static']


Cluster  1260
['While drug abuse among adolescents and young adults has begun to decline from the epidemic levels of the late 1970s , it remains a serious national health problem .', 'The use of alcohol and drugs amongst young people is a serious concern and the need for effective prevention is clear .', 'Substance abuse among young people has become a serious public health problem for years .', 'Substance use disorders are a serious public health concern that affect approximately one in 12 individuals 12 years and older .', 'Adolescent substance use has become a serious concern nationwide .', 'Young people who engage in multiple health risk behaviors such as alcohol and other drug use , unprotected sexual activity , smoking , and violence , are a serious public health concern .', 'The burden of cannabis and other illicit drug use among youth represent a serious public health problem .', 'Substance use ( SU ) problems are common among adolescents , a serious health risk for them and a major public health problem , but are inadequately addressed in most pediatric health care settings .', 'Psychoactive substances use among adolescents is a serious public health problem , as it exposes them to risks and health hazards and can ultimately lead to dependence .', 'Concurrent mental health and substance use issues are a serious problem for adolescents and transition-aged youth .', 'Substance use disorders among youth remain a serious public health problem .', 'Substance use by adolescents and young adults continues to be a serious problem .', 'Alcohol misuse amongst young people is a serious concern .', 'Adolescent substance use ( SU ) remains a serious problem .', 'Drug addiction , particularly among teenagers and young adults , has become a serious public health problem globally .', 'Adolescent substance use disorder ( SUD ) is a serious public health concern .', 'Cigarette , alcohol and substance use is a worldwide threat which especially affects young people and a preventable public health problem .', 'Student substance abuse is a serious concern for middle school personnel .', 'The concurrent or sequential usage of multiple substances during adolescence is a serious public health problem .', 'Adolescent alcohol use is a serious problem in Australia and other nations .', 'Adolescent substance use is a serious problem often invoking negative reactions .']


Cluster  56
['Seventy-two screws were inserted in each group.', 'The mean total costs were 80.', 'The cost difference resulting from the choice of mesh was $124·7 (€118·1).', 'Average annual costs were as follows: GWs, ¥34,424; suspected CIN/CC, ¥6,240; CIN 1, ¥17,484; CIN 2, ¥46,583; CIN 3, ¥166,227; and CC, ¥474,756.', 'The plaque was concentric in 723 sections (50.']


Cluster  1705
['Forty-four participants (20.', 'Twenty parturients were included.', 'Twenty-five women were included in each group.', '20 participants were interviewed.', 'Of the total sample, 20.']


Cluster  946
['The mean 24-h post-transfusion recovery of Test and Control RBCs was comparable (83·2 ± 5·2 and 84·9 ± 5·9%, respectively; P = 0·06) and consistent with the US Food and Drug Administration (FDA) criteria for acceptable RBC viability.', 'RBCs derived from Mirasol WB and stored for up to 21 days in AS-3 maintained acceptable cell quality and recovery, albeit modestly reduced compared with untreated RBCs.', 'In anaemic patients, RBC transfusion induced a significant increase in ScvO<sub>2</sub> , provided it was low before transfusion.', 'Participants requiring chronic RBC transfusions were enrolled in a crossover design study to receive fresh (<7 days of storage) or standard (up to 42 days of storage) blood on 2 separate visits.', 'Transfusions of standard issue blood are associated with less favorable effect on microvascular endothelial function as compared to fresh blood.', 'Red blood cell immunization is a serious problem in transfused patients .', 'Proinflammatory cytokines are increased after RBC transfusion.', 'We found a statistically significant nonlinear pattern in the relation between PV and odds of transfusion of both 1 or more units RBC (χ<sup>2</sup>\xa0= 116.', 'In the WRBC group, the changes in the serum potassium levels at the 3rd, 4th, and 6th hours after transfusion were significant compared with pretransfusion levels.', 'In a single-blind, randomized, controlled, two-period crossover study (n = 42 healthy subjects), amustaline-treated (Test) or Control RBCs were prepared in random sequence and stored for 35 days.']


Cluster  1437
['Personal wellbeing improved significantly across the 9-months of the study.', 'Differences in the mean of mental health scores over time were significant and showed an increasing trend (P<0.', 'In three RAND-36 domains (social functioning, role physical, role emotional) MC procedure was significantly better than LC.', 'Symptoms of depression decreased over time in both groups.', 'The primary outcome was to measure physical health and emotional well-being.', 'We observed significant differences in the experimental group for both quality of life and illness behavior.', 'Functional Independence Measure Self-Care subscores increased 22.', 'Significant differences between the two groups were observed in six of the eight SF-36 domains: Physical Functioning, Bodily Pain, General Health, Mental Health, Social Functioning, and Vitality.', 'At a 6-month follow up, the intervention group improved physical self-perception in all subdomains and significantly improved physical condition, physical self-worth and self-related health compared to the control group.', 'The rehabilitation intervention group had significantly better scores than the control group for comprehensive health, physical function, psychological function, social function, and general health.', "There was a significant positive change in everyday functioning and in the SIX-item 'friendship' at 18-months follow-up.", 'Signs and symptoms significantly improved at different time points in the treatment group.', 'There were significant improvements in caregiver burden, mental health, and depression after post-test and 3 months after post-test in the experimental group.']


Cluster  624
['Cancer , a serious public health problem in worldwide , results from an excessive and uncontrolled proliferation of the body cells without obvious physiological demands of organs .', 'Expression of p53 was greater in basal layers than in para-basal layers.', 'Genomic instability and mutations underlie the hallmarks of cancer-genetic alterations determine cancer cell fate by affecting cell proliferation , apoptosis and immune response , and increasing data show that mutations are involved in metastasis , a crucial event in cancer progression and a life-threatening problem in cancer patients .', 'The eradication of cancer remains a vexing problem despite recent advances in our understanding of the molecular basis of neoplasia .', 'Expression of p53 was inversely related to clinical response to the supplements.', 'Interactions between genes and environment are critical factors for causing cancer in humans', 'Breast cancer poses a serious public health problem , and it is hoped that identification of genetic and environmental factors that contribute to the development of breast cancer will enhance prevention efforts .']


Cluster  331
['At the conclusion of the intervention, the two groups had significant improvement in muscular strength, motor proficiency, running and agility, predilection for physical activity and generalized self-efficacy.', "Children's physical fitness is an important predictor of metabolic health, physical function, and academic achievement", "The most common motivator was 'physical activity is good for health' [34 (68%)].", 'Both physical activity and aerobic fitness were measured.', 'We conducted an internet-based randomised controlled trial recruiting 809 adults to test whether an LKM course improves well-being through evoking pleasant emotions, psychological resources, and altruism compared to a light physical exercise course (LE).', 'A continuing problem with recruiting participants for a project involving exercise is that the volunteer population tends to be healthy and interested in physical activity .', 'Participants (n\xa0=\xa094) were new gym members with the intention to engage in PA but below international PA guidelines at baseline, who were randomized into a control or habit experimental group.', 'The PWS children demonstrated largely intact hormonal, glycolytic, and lipolytic responses to lower-body resistance exercise.', 'Our findings indicate improvements in healthy eating and physical activity, and social connections among program participants, as well as efforts by community organizations to create environments to support healthy weights.', 'The intention-behavior gap has proven to be a vexing problem for theorists and practitioners interested in physical activity .', 'There was improvement in speed and walking distance in both groups.']


Cluster  800
['Human noroviruses are one of the main causes of foodborne illnesses and represent a serious public health concern .', 'Among the enteric viruses implicated in foodborne outbreaks , the human norovirus and hepatitis viruses A and E ( HAV and HEV ) represent a serious public health concern .', 'Human enteric viruses are a major causative agent of emerging waterborne diseases and constitute a serious public health concern .', 'Shellfish contamination by human noroviruses ( HuNoVs ) is a serious health and economic problem .', 'Viral enteritis is a serious problem accounting for deaths in neonatal animals and humans worldwide .', 'Human pathogenic viruses might be a serious problem for bathing water quality and sustainable summer tourism .', 'Viruses that infect the intestine include major human pathogens ( retroviruses , noroviruses , rotaviruses , astroviruses , picornaviruses , adenoviruses , herpesviruses ) that constitute a serious public health problem worldwide .', 'The worldwide high morbidity and mortality associated with norovirus infections , particularly among the elderly , immunocompromised patients and children , constitute a serious public health concern .', 'Human noroviruses ( HuNoV ) , which are responsible for acute gastroenteritis , are becoming a serious public health concern worldwide .']


Cluster  2097
['To evaluate the effect of the protective ventilation strategy on the function of vascular endothelial cells.', 'Combined local discomfort because of draught and vertical temperature difference does not seem to be a serious problem in rooms with displacement ventilation .', 'Persistent air leak is a serious problem that may cause empyema , hypoxia , respiratory insufficiency , and other life-threatening complications .', 'Intubation and extubation generate large amounts of small particles that remain suspended in air for long durations and disperse through theatre.', 'The percentage of prolonged air leak was 11% in the DCD group and 5% in the classic group (P=0.', 'The respiratory epithelium is mainly constituted by caliciform (produces mucus, responsible of keeping moisture and trapping particles) and ciliated cells (transports mucus into the pharynx, by the movement of multiple cilia).', 'Actuating the pMDI into a small-volume nonelectrostatic VHC during exhalation reduced by 11% the amount of fluticasone captured at the exit of the VHC.']


Cluster  344
['To investigate the effect of a compression bandage applied to the pastern region on proximal diffusion of contrast medium injected over the palmar digital nerves.', 'The aim of this study was to evaluate the effectiveness of UltraBLOX™ radiation attenuating hand cream during lengthy cardiac catheterization procedures in children.', "Two nanoDot™ dosimeters were secured side by side on the dorsum of the operator's (n\u2009=\u20092) left hand close to the wrist.", 'A dose-response characteristic was demonstrated in the treatment of trigger finger with triamcinolone acetonide.', 'Twenty mg intravitreal injections of triamcinole acetonide (IVTA) were applied to 110 DME patients after ineffective laserphotocoagulation or as an initial treatment.', 'UltraBLOX™ cream provides a new option for radio-protection for the hands of interventional cardiologists without impairing tactile sensitivity.', 'The compression bandage reduced proximal diffusion and lymphatic drainage of contrast material causing it to stay localised around the injection site.', 'To evaluate the efficacy and safety of intralesional triamcinolone injections compared with 0.']


Cluster  798
['A 12-week randomized controlled trial was conducted in 52 postmenopausal women, age 50-70 years.', '69 women participated in this study and then they were randomly allocated to complex exercise group (n\xa0=\xa035) or the conventional decongestive therapy group (n\xa0=\xa034).', "An observational cohort study was conducted at The Royal Women's Hospital NISC Unit in Melbourne, Australia.", 'From April to June 2019, 100 women were enrolled in the study and were divided into two homogeneous groups.', 'ICPP women (n = 23) were compared with healthy age-matched controls (n = 23).', 'An observational, cross-sectional study was conducted involving 30 asymptomatic women as the control (mean age: 25.', 'A prospective database was analysed from March 2003 to January 2014 (130 months, 990 women).', 'Thirty women (age 20-52 years) were recruited into a 12-week, double-blind, placebo-controlled intervention for CA-ext treatment, where they were randomly allocated to a left or right armpit group.', 'We observed a cohort of 500 women at age 13-89 years (median of age 37.', 'In this study, we evaluated 145 women with HT and 60 age-matched healthy controls.', 'A prospective, randomized, double-blinded, comparative clinical trial involving 52 adult female subjects was performed.', 'A prospective cohort of 22 women and two men has been evaluated.', 'Twenty females recruited from two hospitals participated in this study.', 'Forty (30 women, age 36±11 y) participants completed the study, 33 with LBP (13 MT, 13 sham ultrasound treatment, and 7 no treatment) and 7 without LBP.', 'Five female volunteers were enrolled in this inpatient, controlled pilot study.', 'One hundred subjects (mean age 58 [SD13], 54% females) were included in this trial.', 'This is a secondary analysis of a randomized controlled trial conducted in 59 women who received an 8-week CT or BLT and completed questionnaires evaluating depression and possible moderating variables.', 'Seventeen healthy female volunteers aged 50 and over and presenting lentigines participated in the study from spring to summer.']


Cluster  1568
['Lead contamination is a serious environmental problem with toxic effects in human .', 'Environmental lead ( Pb ) is a serious public health problem .', 'Lead ( Pb ) pollution is a serious problem in the developing countries , especially in South Asia .', 'Lead ( Pb ) contamination in the air is a severe global problem , most notably in China .', 'Despite the well-known toxicity and the efforts to control its exposure , lead still has a serious health concern , particularly in young ages .', 'The continued occurrence of occupational lead overexposure and lead poisoning in the United States remains a serious problem despite awareness of its adverse health effects .', "Workers ' blood lead levels were brought down from 114.4 , 110.0 and 120.6 mg/dL with treatment of D-penicillamine to 40 mg/dL. It may be concluded that lead poisoning is a preventable public health problem that particularly affects the industrial workers in small lead-based units .", 'Preventive measures in Central Europe were successful in suppressing both occupational and environmental lead exposure so that they did not constitute a severe public health problem .', 'Both occupational and environmental exposures to lead remain a serious problem in many developing and industrializing countries and a public health problem of global dimensions .', 'Lead intoxication is a serious occupational disease that constitutes a major public health problem .', 'Lead contamination is widespread across China , posing a serious public health concern .', 'Asymptomatic lead poisoning remains a serious public health problem in developed and developing countries .', 'Lead ( Pb ) contamination of soil is a serious environmental problem , adversely affecting ecosystems , globally .', 'Childhood lead poisoning is a serious public health concern worldwide .', 'Exposure to lead hazards is a serious health concern for inner-city children .', "Lead ( Pb ) pollution is a serious public health problem all over the world , it especially plays severe damage role in children 's health .", 'Lead ( Pb ) poisoning in raptors and water birds is a serious problem in many countries .', 'Prior calculations of the burden of disease from environmental lead exposure in low- \xa0 and middle-income countries ( LMICs ) have not included estimates of the burden from lead-contaminated sites because of a lack of exposure data , resulting in an underestimation of a serious public health problem .', 'Lead (Pb)-based paints pose a serious health problem to people living in residential settings constructed prior to 1978 .', 'We concluded that lead poisoning is still a serious threat to waterfowl in Japan and that there is considerable need for environmental improvement concerning this problem .', 'We conclude that lead exposure does not constitute a serious health problem in the area studied , since BPb levels found are far below the toxic limit and the prevalence of intoxication is similar to that reported in other studies conducted in other developed countries .', 'Environmental lead exposure remains a serious concern for the growth and development of children .', 'Occupational exposure to lead fumes constitutes a serious problem in Egypt , since a considerable number of workers might be involved in its deleterious effect .', 'Lead ( Pb ) toxicity has been a serious concern in industrialized societies because of its association with functional deficits in nervous , haematopoietic and renal systems .']


Cluster  1912
['The results of the present study show better osseointegration of the heterologous graft when nanohydroxyapatite is added.', 'At Time 0, the mineral density of the nanohydroxyapatite group appeared significantly higher compared with the pure graft group, due to the presence of NHA.', 'Based on this material development and advancement for a dual setting system , we managed to overcome the drawback of brittleness for pure calcium phosphate cements .']


Cluster  708
['Laser Doppler flowmetry (LDF) was used to measure SBF on the triceps in 12 healthy participants in this repeated measures study.', 'In individuals with ISBPD at PRE, active recovery from exercise attenuated the difference between interarm SBP.', 'To determine whether supervised weekly exercise influences BRS, and to determine if posture and calculation method are important in antenatal BRS measurement.', 'Weekly exercise exaggerated the reductions in BRS and HRV during pregnancy and is likely linked to diminished parasympathetic activity.', 'Our results indicate that acute elevations in peripheral BP are an important determinant of AIx during muscle metaboreflex activation in healthy men.', 'After 12 weeks of brisk walking, SBP of TRG during resting, low and high-intensity exercise was significantly reduced by 8.', 'An experienced investigator sequentially measured SBP using standard auscultation in each arm (alternating order) in 85 normotensive individuals (22±6 years, 39 male, 46 female).', 'The subjects were 78 normotensive females with (n = 25) and without (n = 53) an exaggerated SBP response to exercise who were not taking any medications.', 'After 12-week intervention, the exercise-induced SBP elevation decreased in an exaggerated SBP response group (P < 0.']


Cluster  959
['The aim was to explore health literacy and views about being invited to screening, among participants and non-participants in a national colorectal cancer screening program.', 'Intervention was a previously validated invitation to inform the decision to attend screening , presenting diabetes as a serious potential problem , and providing details of possible costs and benefits of screening and treatment in text and pie charts .', 'This paper describes the first systematic evaluation of a newly developed decision aid for the German mammography screening programme in a randomised controlled trial.', 'To determine whether a decision aid increases informed choice about mammography screening programme participation.', 'Risks could be communicated using decision aids with only one graphic.', 'A written invitation to undergo testing of the stool for blood, together with an accompanying test, increased the participation rate within one year by 62% (from 15% to 25%, p <0.', 'Unlike most regions where inequalities are graded along the socioeconomic continuum, inequalities in the uptake of colorectal cancer screening in Spain seem to be concentrated first in the most disadvantaged group and second in the least deprived group.']


Cluster  1907
['Patients walked an average of 5,281 steps/day and slept 370.', 'Patients in a suburban environment walked much less than those in a previously studied urban population.', 'The present study revealed complex mobility patterns among patients, which are affected by numerous personal as well as clinical factors.']


Cluster  675
['Smoking is a serious problem in the South-eastern Anatolian Region .', 'Smoking in University of Chengdu , China is a severe problem .', 'An increase in hookah smoking is considered to be a serious health problem in societies withdifferent cigarette smoking patterns .', 'Cigarette smoking is a serious problem among Greek youth .', 'Tobacco use is a serious public health problem among Arab Americans with limited English proficiency .', 'Tobacco smoking and its consequences are a serious public health problem in Romania .', 'In utero tobacco consumption is a serious public health problem in France ; it is very frequent and the long term consequences are not only numerous but also misinterpreted by our population .', 'Although smoking behavior is a serious problem among Arab American immigrants in general and in the Arab world in particular , cultural factors that support healthy behavior during pregnancy in the Arab culture seem to limit the use of tobacco in pregnant women .', 'Smoking in Jordan is a serious problem as it affects almost all segments of society including children .', 'Tobacco use is a serious health concern in Albania .', 'Tobacco use is a serious public health problem among low-income Chinese Americans with limited English proficiency .', 'Cigarette smoking is a serious health problem in China , not only in adults but also in adolescents .', 'Smoking during pregnancy is a serious public health problem in need of better treatments .', 'Results suggest that smoking will continue as a serious problem among Thai males and demonstrate the addictive nature of cigarette smoking which persists in spite of the increasingly negative evaluative attitudes of users .', 'Cigarette smoking among low-income African Americans : a serious public health problem .', 'With almost one fifth of college-going youth smoking and a higher prevalence in older age groups within them , smoking is a serious concern for young people in Western Nepal .', 'Cigarette smoking is a serious health problem throughout the world , with a complicated and not totally clear bio-effect .', 'Altogether this study emphasizes the importance of active smoking as a serious public health problem particularly for children and women .']


Cluster  873
['Pain is a serious secondary problem for many persons with cerebral palsy ( CP ) .', 'Pain is a serious problem for many individuals with cerebral palsy ( CP ) .', 'Poor nutrition is a serious problem in children with cerebral palsy in Palawan , the Philippines .', 'Comparing the groups, the tetraparesis cerebral palsy patients fed orally have a greater impairment of their nutritional status, even though they have higher intakes of protein and fiber than those patients fed by gastrostomy, demonstrating a consistent argument for the use of gastrostomy.', 'Cerebral palsy is a serious world-wide problem ; its incidence ranges from one to five per thousand of live-born children and is much influenced by gestation age and birth weight .', "Pott 's paraplegia associated with pregnancy is a serious problem and is difficult to treat , as not much literature is available regarding its management .", 'To compare nutritional status and diet of pediatric patients with tetraparesis cerebral palsy who are fed by GTF with those fed orally (PO).', 'Perinatal brachial plexus palsy ( PBPP ) constitutes a serious medical problem .']


Cluster  1865
['Monetary incentives can alter health behavior engagement without decreasing intrinsic motivation or other relevant cognitive and motivational constructs.', 'An RCT of an incentive intervention is feasible.', 'Participants in the daily incentive condition demonstrated the greatest increase in self-reported consumption during the intervention and at the follow-up.', 'Individuals reporting insufficient fruit and vegetable consumption were randomly assigned to receive either daily monetary incentives, delayed monetary incentives, or no incentives for their fruit and vegetable consumption during a 3-week intervention period.', 'We conducted a qualitative observational study nested within a larger RCT of financial incentives to improve hypertension care.']


Cluster  1760
['Cerebrospinal fluid ( CSF ) rhinorrhea is a dangerous problem .', 'Spontaneous cerebrospinal fluid leak of the temporal bone is an emerging clinical entity for which prompt and accurate diagnosis is difficult given the subtle signs and symptoms that patients present with.', 'Sixty-one patients with spontaneous cerebrospinal fluid leak were identified.', 'The average cerebrospinal fluid (CSF) drainage volumes were analyzed.']


Cluster  1226
['Within the Geminiviridae family , a group of plant-infecting viruses that severely constrain cropping systems worldwide , it is highly suspected that recombination was pivotal in the emergence as a devastating phytopathological problem .', 'Grape virus diseases are a serious problem in Iran .', 'The new disease has become a serious problem for tomato production in Europe .', 'These viruses can cause a serious problem to other leguminous crops grown in Iran .', 'A laboratory study demonstrated that BBrMV could be transmitted from flowering ginger to its natural host , banana , therefore raising a serious concern about the potential risk to the rapidly growing banana industry of Hawaii .', 'For > 20 yr , Bemisia tabaci Gennadius persists as a begomovirus vector and is a serious problem in tomato production in many parts of the world .', 'The Brazilian strain of Cowpea aphid-borne mosaic virus ( CABMV ) is a severe pathogen in peanut and a significant problem when distributing germ plasm to other countries .', 'BmNPV is a major cause of production loss and is a serious problem for Paraná sericulture .', 'Bombyx mori entomopathogenic virus infection is a serious problem for silk production in tropical regions .', 'A significant reduction in yield and quality due to virus infection is now a serious economic problem ( 1 ) .', 'In recent years , infectious bursal disease virus ( IBDV ) has become a serious economic problem as a result of the emergence of new and very virulent strains .', 'Tomato yellow leaf curl virus ( TYLCV ) , a member of the genus Begomovirus , is responsible for one of the most devastating viral diseases in tomato-growing countries and is becoming a serious problem in many subtropical and tropical countries .', 'Leaf curl disease is a serious concern for tomato crops caused by begomovirus in Jeddah , Kingdom of Saudi Arabia .', 'Potato virus Y ( PVY ) is a serious problem for potato production worldwide .']


Cluster  142
['Active/passive transforms , changing words with synonyms , and rephrasings of the same idea are all examples of transformations that paraphrases can use -LRB- others can be used too -RRB- . the computational complexity of working with SVMs', 'Research on paraphrase alignment focuses on identifying links between semantically related word strings . the type-checking which is not fully implemented', 'We used two well-known benchmark data collections for text classification , the Reuters-21578 collection 3 and the 20 Newsgroup collection 4 . the low number of paraphrases', 'We focus briefly on the issue of feedback in SLT systems , pointing out the difficulties of relying on text-based paraphrases', 'In spite of their success , a key limitation of phrase-based systems is that they make little or no direct use of syntactic information', 'In short , one important shortcoming of existing large scale semantic grammars is that they do not assign semantically equivalent sentences the same semantic representation', "Brill and Resnik -LRB- 1994 -RRB- use Brill 's transformation-based algorithm along with simple counts within a lexical hierarchy in order to generalize over individual words . the exponential relationship between the number of possible paraphrases of a summary of a set of facts and the number of facts in that set", 'We used two well-known benchmark data collections for text classification , the Reuters-21578 collection 3 and the 20 Newsgroup collection 4 . the low number of paraphrases', 'Furthermore , integrating the knowledge about multi-word expressions into the word alignment models is another future direction for this work . the system does not take into account constraints from mentions outside of the ( mention , antecedent ) pairs', "Brill and Resnik -LRB- 1994 -RRB- use Brill 's transformation-based algorithm along with simple counts within a lexical hierarchy in order to generalize over individual words . the exponential relationship between the number of possible paraphrases of a summary of a set of facts and the number of facts in that set", 'Building paraphrase typologies from different perspectives -LRB- e.g. , linguistics analysis and discourse analysis -RRB- has been an active research area for a number of years now -LRB- Vila et al. , 2011 -RRB- . all existing systems can be used for analysis but not for generation', "Brill and Resnik -LRB- 1994 -RRB- use Brill 's transformation-based algorithm along with simple counts within a lexical hierarchy in order to generalize over individual words . the exponential relationship between the number of possible paraphrases of a summary of a set of facts and the number of facts in that set"]


Cluster  931
['Geophagia , the deliberate ingestion of earth , is a serious clinical problem , particularly for dialysis patients .', "Between January 2012 and December 2015, at the Department of Urology, Huai'an First People's Hospital, 150 consecutively enrolled patients with a large upper impacted ureteral stone (>15\xa0mm) were included.", 'Urinary stone disease is a severe problem in Turkey , with high prevalence and incidence rates , which differ significantly between ethnic groups .', 'We confirmed relevance of Non-stone group patients as a control subject by comparing the pair-matched community-dwelling volunteers.', 'Computed tomography (CT) is generally used for ureteral stone diagnosis.']


Cluster  573
['The emergence of multiple antibiotic-resistant bacteria is a serious global problem which requires the development of new effective antimicrobial therapeutics .', 'Treatment of bacterial infections has become more effective with the advent of broad-spectrum antibiotics ; however , the dreadful emergence of polyresistant strains may be a serious problem in the near future .', 'The alarming number of recently reported human illnesses with bacterial infections resistant to multiple antibacterial agents has become a serious concern in recent years .', 'It has become a serious public health problem whose solution requires medical research in order to explore novel effective antimicrobial molecules .', 'Its intrinsic and acquired resistance to various antimicrobial agents and its ability to develop multidrug resistance imposes a serious therapeutic problem .', 'As drug resistance is becoming a threatening problem , it is necessary to develop new antimicrobial agents with novel mechanisms of action .', 'However , resistance to arbekacin , which is caused mainly by the bifunctional aminoglycoside-modifying enzyme , has been observed , becoming a serious problem in medical practice .', 'An alarming increment in pathogenic resistance to existing anti-microbial agents is a serious problem and the treatment of these bacterial infections is becoming increasingly challenging .', 'Multidrug-resistant pathogens have become a serious problem in modern chemotherapy .', 'An increasing number of multidrug-resistant pathogens is a serious problem of modern medicine and new antibiotics are highly demanded .', 'The increased resistance of glycopeptide based antibiotics has become a serious problem for the chemotherapy of infections triggered by resistant Gram-positive bacteria .', 'Multi- drug resistant microbial pathogens are a serious global health problem and thus new antibacterial agents , which are effective both alone and in combination with traditional antibiotics , are urgently needed .', 'There is an urgent need to discover novel antibiotics to overcome the growing problem of antibiotic resistance , which has become a serious concern in current medicine .', 'The emergence of drug-resistant pathogens leads to a gradual decline in the efficacy of many antibacterial agents , which poses a serious problem for proper therapy .', 'There is a dire need for the discovery and development of new antimicrobial agents after several experiments for a better resistance of microorganisms towards antimicrobial agents become a serious health problem for a few years in the past .', 'High level resistance to aminoglycosides is a serious therapeutic problem , since it predicts the loss of synergistic activity of this antimicrobial combination .', 'The continued emergence of drug-resistance to existing antibacterial agents represents a severe and ongoing public health concern , which demands the discovery of new antibiotics .', 'New antibiotics are available to overcome non-susceptibility in grampositives ; however , accumulation of resistance traits in gramnegatives has lead to multidrug resistance , a worrisome problem nowadays .', 'Increasing resistance of the disease to antibiotics is a severe problem in treatment regime and has led to intensification of the search for new drugs .', 'Infectious diseases and the rapid development of pathogens resistant to conventional drugs are a serious global public health problem , which motivates the search for new pharmacological agents .', 'Bacterial resistance to antibiotics has become a serious problem in antibacterial chemotherapy and resistance of bacteria to chemically-unrelated anti-microbial agents can be associated with the over-expression of efflux pumps .', 'Antimicrobial drug resistance is a serious public health problem and the development of new antibiotics has become an important priority .', 'Resistance to currently used drugs is a serious problem in most fields of antimicrobial chemotherapy .']


Cluster  1153
['Management of household solid waste and agro industrial residues generated from various sources is a serious problem due to huge ever increasing population and pollution .', 'Furthermore , some of the byproducts of animal slaughtering can not enter food and feed chains and thus their disposal possesses a serious environmental concern .', 'Significant losses and waste in the fresh and processing industries are becoming a serious nutritional , economical , and environmental problem .', 'Processed milk waste ( MW ) presents a serious problem within the dairy industries due to its high polluting load .', 'SRM disposal is a serious concern for abattoirs and the beef industry .', 'Biogas slurry has become a serious pollution problem and anaerobic digestion is widely applied to pig manure treatment for environmental protection and energy recovery .', 'Food waste is a serious problem for food processing industries , especially when it represents a loss of a valuable source of nutrients and phytochemicals .', 'Animal breeding and management of organic wastes pose a serious problem to the health of livestock and workers , as well as the nearby residents .', 'With the expansion of livestock industry and the dramatic increasing yield of manure compost , the N2O emission during the aerobic composting has become a severe problem .', 'Plant biomass and agricultural waste products disposal is a serious problem in agriculture based countries .', 'Therefore , the present investigations recommend the use of carbon slurry waste as inexpensive adsorbent for small scale industries of developing/poor countries where disposal of solid waste of various industries and proper treatment of polluted wastewater is a serious problem .', "The rapid development of livestock production in China has brought livestock manure pollution as a serious environment problem , even threatens China 's agriculture sustainable development ."]


Cluster  1251
['The problem with this approach is that creating these rules requires much cost and that they are usually domain-dependent', 'We hope that existing efforts that are already well-disposed toward electronic distribution will participate . creating these rules requires much cost and that they are usually domain-dependent', 'We hope that existing efforts that are already well-disposed toward electronic distribution will participate . creating these rules requires much cost and that they are usually domain-dependent']


Cluster  1323
['Diabetes is a serious public health concern in the UK .', 'Type 2 diabetes is a serious and growing problem in Taiwan where it is the fifth leading cause of death , and health care costs are 4.3 times higher than for people without diabetes .', 'The incidence of type 2 diabetes mellitus ( non-insulin-dependent diabetes mellitus ) is growing worldwide and poses a serious public health problem in a current paradigm of changing life style and food habits .', 'Diabetes mellitus is a true pandemic ; type 2 diabetes in particular , with its progressive nature , constitutes a serious health problem .', 'Type 2 diabetes mellitus represents a serious medical , social and economic problem , since it has become a pandemic in recent years , affecting up to 1/3 of the Czech population in old age .', 'Type 2 Diabetes Mellitus is a serious health problem . In the year 2030 it will affect 366 million people around the world .', 'Affecting more than 6 % of the population in the United States , type 2 diabetes and its complications have become a serious public health concern that exerts a substantial toll on the individuals affected , the entire health care system , and the economy , including employers .', 'Type 2 diabetes is a prevalent chronic disease arising as a serious public health problem worldwide .', 'Type 2 diabetes mellitus ( T2DM ) is rapidly prevailing as a serious global health problem .', 'Type 2 diabetes mellitus is considered one of the fastest growing diseases in Canada , representing a serious public health concern .', 'Type 2 diabetes is a serious clinical problem in both India and the UK .', 'Type 2 diabetes mellitus ( T2DM ) is a serious public health problem accompanies with several complications .', 'Type 2 Diabetes Mellitus ( T2DM ) is a serious problem in the world .', 'The rising epidemic of type 2 diabetes mellitus & associated complications is a serious cause of concern for humanity .']


Cluster  1967
['Inorganic urban solid waste ( IUSW ) is a serious problem in developing countries , and IUSW in the street that does not have adequate final disposal is responsible for serious environmental effects .', 'A mass of construction and demolition ( C&D ) waste are generated in Shanghai every year , and it has become a serious environment problem .', 'Solid waste management is one of the most challenging issues in urban cities , which are facing a serious pollution problem due to the generation of huge quantities of solid waste .', 'The enormous quantities of municipal solid waste ( MSW ) generation in Indian cities has emerged as a serious concern .', 'Hazardous waste disposal is a serious environmental concern in China .', 'Municipal solid waste ( MSW ) management is a serious problem for public administrations , especially in terms of treatment and final disposal .', 'The disposal of household hazardous waste and materials as municipal solid waste ( MSW ) remains a vexing problem for solid waste managers and policymakers .']


Cluster  1186
['A serious drawback of thermal ablation , however , is that the ablation area can not be accurately assessed during the procedure .', 'Twelve patients with rhinophyma, between 50 and 80 years of age, received 4 monthly treatment sessions with a fractional ablative CO2 laser.', 'A major drawback of cryoablation is its lack of reliable and complete ablation of all prostate cells .', 'Cryo-surgery using the three-phase protocol as described may improve the overall outcome of future ablation procedures.', 'Superficial full surface ablation with a depth of 144\xa0μm is an effective recipient-site preparation before cell suspension transplantation, while fractional CO<sub>2</sub> laser is not.', 'CB ablation can sometimes be challenging.', 'Instead of using EMLA, FCAA-which can be applied in a shorter time-may be a cost-effective, simple, and safe local anesthesia method used in the ablative fractionated CO<sub>2</sub> laser procedure.', 'Laser-induced ignition of endotracheal tubes is a serious problem in CO2 laser surgery of the upper aerodigestive tract .']


Cluster  886
['Infertility can be a devastating problem for a couple desperate to conceive .', 'There is an urgent need to recognize infertility as a serious reproductive health problem and to put infertility care on the public health agenda .', 'Male infertility is a vexing yet common problem for men all over the world .', 'Male factor Infertility is a devastating problem from which a notable percentage of couples suffer .', 'Infertility is a serious social problem in advanced nations , with male factor infertility accounting for approximately half of all cases of infertility .', 'Infertility is a serious public health problem worldwide .', 'Infertility is a serious social problem in advanced nations today .', 'Male infertility is a serious problem , and its prevalence has been increasing .', 'Recently , gradual decline in human sperm production has become a serious worldwide concern because it leads to increased rates of infertility .', "Infertility is a serious problem in a couple 's life that affects their marriage relationships .", 'Despite advances in Assisted Reproductive Technologies , infertility has remained a serious problem .', 'Male infertility is a devastating problem that affects many couples worldwide .', 'Infertility is common , a serious medical problem in both advanced and underdeveloped countries .', 'Male infertility is a serious problem in an increasing number of couples .']


Cluster  1783
['Mathematically , a proportion is the cardinality of a set divided by the cardinality of a superset . finding infrequent but important product features', 'Mathematically , a proportion is the cardinality of a set divided by the cardinality of a superset . finding infrequent but important product features']


Cluster  1699
['Hearing loss is the most common sensory deficit in the elderly , and it is becoming a severe social and health problem .', 'Permanent childhood hearing impairment is a serious public health problem .', 'Hearing loss is a serious problem with farmers , and yet many farmers neglect to protect their hearing with the use of protection .', 'Fourteen native Mandarin-speaking adult patients, aged 20-65 years with bilateral, moderate to severe, sensorineural hearing loss, specifically high frequency hearing loss were included in single-blind randomized study.', 'Hearing loss is the most common sensory deficit in the elderly , and is becoming a severe social and health problem .', 'Hearing loss can present at birth or be acquired as a result of illness, middle-ear disease, injury, age, overuse of certain medications, and/or induced by exposure to damaging noise levels', 'Sudden sensorineural hearing loss seems to become a serious social health problem in modern societies .', '2 . Hearing loss is a serious health problem among the elderly .', 'Deafness is a hidden handicap in infancy although lack of vestibular function may delay motor milestones like sitting and walking but does not constitute a serious problem after they are achieved .', 'Given that by 2018 , more than 400 million people worldwide were suffering from disabling hearing loss and that about one-third involved noise over-exposure , which represents more than 100 million people , this hearing impairment represents a serious health problem .']


Cluster  694
['Corticosteroid-naïve patients appeared to benefit the most from the Adacolumn GMA, and attain a favourable long-term clinical course.', 'This localized , disease-associated GC resistance is a serious therapeutic concern and limits therapeutic response in patients with chronic inflammatory disease .', 'The development of glucocorticoid ( GC ) resistance is a serious problem that complicates the treatment of immune-related diseases , such as asthma , ulcerative colitis , and hematologic cancers .', 'The GC resistance is a serious therapeutic problem and limits the therapeutic response of GC in chronic inflammatory patients .', 'This is a serious problem because it limits the full therapeutic exploitation of the anti-inflammatory power of GCs .', 'The withdrawal of patients from chronic glucocorticoid therapy can be a vexing problem .', 'Glucocorticoid resistance ( GCR ) , i.e. unresponsiveness to the beneficial anti-inflammatory activities of the glucocorticoid receptor ( GR ) , poses a serious problem in the treatment of inflammatory diseases .', 'Glucocorticoid ( GC ) resistance is a severe problem associated with various inflammatory diseases .']


Cluster  214
['Onset time in the olanzapine group was significantly earlier than in the haloperidol group; BPRS scores in the olanzapine group were significantly lower than haloperidol group values at 1 and 2 weeks of treatment.', 'As predicted, ERN was reduced by haloperidol and in those exhibiting less adaptive post-error performance; however, these effects were limited to ERNs following fast timing errors.', 'Olanzapine produced reduction in all dimensions, but the pace of responding of individual dimensions differed.', 'A common and serious drawback of the conventional antipsychotics is their association with a range of motor disturbances : acute extrapyramidal symptoms , including parkinsonism , acute akathisia and acute dystonia ; and chronic motor problems such as tardive dyskinesia , chronic akathisia and tardive dystonia .', 'A prominent drawback of antipsychotics is their negative impact on subjective well-being , initiative , and drive related to dopamine D2 blockade .', 'Although second-generation antipsychotics are used to treat and manage symptoms for several psychiatric disorders, data about their adverse effects in developmental age are limited.', 'The aim of this study was to determine monoamine oxidase A (plasma) and B (platelets) enzyme activity in long-term levodopa-treated patients without and with additional oral intake of 50- or 100-mg safinamide or 1-mg rasagiline or first-time intake of rasagiline.', 'This study examined the effect of adjunctive minocycline on body metabolism in risperidone-treated patients with schizophrenia.', 'A serious concern when using a tricyclic antidepressant to augment an SSRI is the effect of the SSRI on the cytochrome P450 system and the resulting significant increase in tricyclic antidepressant blood concentrations .', 'In our sample, several metabolic parameters showed a sensitivity to risperidone treatment.', 'Short-term olanzapine and haloperidol treatments had equivalent efficacies in the treatment of acute symptoms of mental disorders due to ATSs; however, olanzapine administration resulted in relatively earlier disease onset, with less adverse reactions.']


Cluster  2337
['To compare the efficacy of 1% cantharidin, 20% podophylline resin and 30% salicylic acid (CPS) versus long-pulsed Nd:YAG laser in the treatment of recalcitrant plantar warts.', 'The aim of the present work is to evaluate the efficacy of intralesional injection of bleomycin in the treatment of plantar warts based on clinical and dermoscopic observations.', 'Our aim was to evaluate the efficacy and safety of intralesional injection of a combination of digoxin and furosemide in treatment of plantar warts.', 'This two-armed single blinded randomized clinical trial included 40 cases with multiple plantar warts (≥3warts) divided into 2 groups (20 cases each).', 'This study included 30 patients with single or multiple recalcitrant plantar warts; patients were assigned to two groups: the first group included 15 patients with 71 recalcitrant plantar warts who were treated by long-pulsed Nd:YAG laser (group I) and the second group included 15 patients with 78 recalcitrant plantar warts who received CPS (group II).', 'Treatment of plantar warts is difficult and requires multiple treatments, and they are more refractory to treatment than common warts.', 'Intralesional injection of bleomycin is an effective and safe treatment of plantar warts.']


Cluster  1669
['Thrombotic thromboctopenic purpura is a rare multisystemic life threatening disease the treatment of which is still a serious problem .', 'Drug-Induced Thrombocytopenia : Is it a Serious Concern for Glycoprotein IIb/IIIa Receptor Inhibitors ?', 'We thereby conducted a case series prospective study to compare the ability to predict hemorrhage in ITP patients between platelet counts and various rotational thromboelastometry (ROTEM) parameters.', 'Severe haemorrhagic thrombocytopenia in infectious mononucleosis with positive Epstein-Barr virus ( EBV ) serology remains a threatening clinical problem .', 'PTR is a serious problem in patients being treated for hematologic disorders .', 'NAFLD should be considered as a cause of mild thrombocytopenia.', 'Patients with immune thrombocytopenic purpura (ITP) often present with a severe reduction in platelet counts and suffer from an increased risk of bleeding.', 'Thrombocytopenia is a serious clinical problem in several different clinical settings .']


Cluster  843
['This study provides scientific support for the clinical use of ECOHAIR® as a treatment to be used in noncicatricial alopecia.', 'Dandruff is a troubling consumer problem characterized by flaking and pruritus of the scalp and is considered a multifactorial condition with sebum , individual susceptibility and the fungus Malassezia all thought to play a part .', 'To evaluate the clinical efficacy and safety of carboxytherapy in alopecia areata and androgenetic alopecia.', 'Chemotherapy-induced alopecia is a distressing problem to the cancer patient for which currently there is no effective preventive measure .', 'Traction alopecia is a chronic condition that is difficult to treat.', 'Traction alopecia refers to (often permanent) hair loss caused by prolonged physical damage.', 'Alopecia areata (AA) is one of the most difficult skin diseases to manage well.', 'To identify and compare the characteristics in the gut microbial composition of patients with alopecia areata (AA) and healthy controls (HCs).', 'We studied 25 patients who were clinically diagnosed with traction alopecia.', 'Group IA patients showed significant clinical improvement in SALT score and dermoscopic improvement after carboxytherapy and at the end of follow-up period with significant reduction in dystrophic hair, black dots, yellow dots, and tapered hair coinciding with significant emergence of regrowing hair.']


Cluster  1556
['Arsenic (As)-polluted groundwater constitutes a serious problem for peanut plants , as roots can accumulate the metalloid in their edible parts .', 'Accumulation of arsenic in plants is a serious South-east Asian environmental problem .', 'Arsenic contamination is a serious problem in rice cultivated soils of many developing countries .', 'Arsenic ( As ) in rice grains is a serious food safety concern .', 'High concentration of arsenic ( As ) in rice is a serious problem worldwide .', 'Soil contamination with co-existing arsenic ( As ) and antimony ( Sb ) has become a serious environmental problem worldwide .', 'Soil arsenic ( As ) contamination is a serious concern because of its mark negative impacts on plant growth and physiological processes .', 'Phenyl substituted arsenic compounds are widely used as feed additives in the poultry industry and have become a serious environmental concern .', 'Arsenic ( As ) contamination of rice grain is a serious problem worldwide .']


Cluster  1809
['Environmental pollution still remains a serious problem in some heavily industrialized regions of Poland .', 'Athens has a serious air pollution problem which became evident in the early 1970s .', 'Air pollution is a severe problem in Poland , with Kraków area being among the regions with the worse air quality .', 'North Macedonia , as a developing country , has a serious problem with air pollution .', 'Excessive summer heat is a serious environmental health problem in Skopje , the capital and largest city of the former Yugoslav Republic of Macedonia .']


Cluster  1678
['After a follow-up of 2 years, similar measurements were noted on range of motion and grip strength in both groups.', 'The participants were randomly allocated to the experimental group (EG) receiving robot-assisted left-hand training (n\u200a=\u200a12) or the control group (CG) receiving conventional treatments for neglect symptoms (n\u200a=\u200a12).', 'The obtained data can testify about the improvement of indicators of function of a small motility of brushes on the background of improvement of cognitive functions.', 'We evaluate the importance of skill progression during intensive bimanual practice on movement coordination.', 'To identify the effect of robot training on functional recovery of the arm.', 'To determine the therapeutic effects of high and low levels of robotic assistance during finger training.', 'Given the importance of invoking accurate images to benefit from MI practice, and considering the link between motor capacities and MI, the present study investigated the effect of a rehabilitation program on MI ability in patients with lower-limb amputation.', 'Both groups improved significantly at the 1-month follow-up on functional and impairment-based motor outcomes, on depression scores, and on self-efficacy of hand function, with no difference between groups in the primary endpoint (change in Box and Blocks).', 'Results showed that the imagery protocol was equally effective as PMT in promoting motor skill acquisition, with moderate-to-large effect sizes.', 'Against the background of therapy, the improvement of constructive praxis and short-term memory, an increase in the speed of visual search and visual-motor function, an increase in the level of selectivity of attention, an improvement in the reproduction of visual images and perception, an increase in the speed of the motor task (drawing strokes).', 'Significant improvements in the overall and specific "arm and hand position" as well as "activities" from the Chailey Levels of Ability and the locomotor stages were observed (P<0.', 'Analyses revealed significant improvement from pre- to post- training assessment on both maintenance WM (Digit Span Forward) and manipulation WM (Digit Span Backward and Letter-Number Sequencing).', 'Before training, movements were variable, tended to undershoot the target, and terminated in contralateral workspace (flexion bias).']


Cluster  1719
['Forty patients were included in each group.', '43 patients completed 4 weeks of assessment.', 'Forty-one participants completed the study.', 'Forty-two patients completed the program.', 'Forty subjects were included and completed the study.', '42 patients were included.', 'Forty-four participants completed the study.', 'Out of 44 initially enrolled subjects, 38 patients aged 41.', 'A total of 43 of 64 randomized patients participated in the follow-up.']


Cluster  129
['To the best of our knowledge, this is the first study describing the trigger factors and clinico-pathological features of dogs with urticaria in veterinary medicine.', 'To evaluate the efficacy and tolerability of subcutaneous ciclosporin administered to cats with allergic skin disease.', 'Canine atopic dermatitis is a common clinical presentation.', 'Twenty four dogs with signs of urticaria with or without anaphylaxis.', 'Ciclosporin administered subcutaneously at initial doses of 2.', 'To evaluate the speed of resolution of clinical signs of bacterial pyoderma in dogs treated with a systemic antimicrobial agent with or without the use of an adjunctive spray with antimicrobial properties.', 'To evaluate the efficacy of a novel TRPM8 agonist, 1-diisopropylphosphorylheptane (Cryosim-1), in atopic dogs.', 'To assess the efficacy of minocycline in the treatment of natural occurring E.\xa0canis infection in dogs.', 'In this pilot trial with a TRPM8 agonist in atopic dogs with pedal pruritus, the twice daily application of a 2% Cryosim-1 cream did not have an antipruritic effect superior to that of its vehicle.', 'Atopic beagle dogs.']


Cluster  1695
['Fungal diseases of creeping bentgrass , an important amenity grass used extensively on golf courses , are a serious problem in golf course management .', 'Sclerotinia homoeocarpa causes dollar spot disease on turfgrass and is a serious problem on many species worldwide .', 'Dollar spot ( Sclerotinia homoeocarpa ) is a severe disease problem on creeping bentgrass ( Agrostis stolonifera ) fairways .', 'Colletotrichum cereale is the causal agent of turfgrass anthracnose , which has become a serious problem on annual bluegrass ( Poa annua ) and creeping bentgrass ( Agrostis palustris ) golf course putting greens .']


Cluster  2075
['A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr)\u2009≥\u20090.', 'Patients developing AKI after cardiac surgery presented high prevalence of long-term incident CKD.', 'Consecutive patients with cardiomyopathy who had received an ICD (n = 120, mean age 64 ± 11 years) were prospectively enrolled.', 'The relationship between the neutrophil-to-lymphocyte ratio (NLR) and outcome in patients with implantable cardioverter-defibrillators (ICDs) is unclear.', 'This is an observational study that included adult CKD patients undergoing cardiac surgery.', 'Evaluating the NLR may be useful for predicting outcomes in patients with cardiomyopathy who have received ICDs.']


Cluster  1103
['PPI chronic treatment decreased the diagnostic accuracy for the studied biomarkers, particularly of gastrin.', 'The average time for completion of a POC test for GAS pharyngitis was 25.', 'Although additional studies are required to further assess service feasibility, this study indicates that a GAS POC testing service could be implemented in a community pharmacy with limited disruption or change to workflow and staff.', 'Novel GCM and GCSM endoscopic findings in the corpus area seem to be strongly associated with PPI use.', 'To asses if chronic treatment with PPIs has an effect on serum gastrin and pepsinogen-I concentrations for the diagnosis of pernicious anaemia (PA).']


Cluster  745
['While these algorithms usually achieve the best performance , as compared to their unsupervised or knowledge-based alternatives , there is an important shortcoming associated with these methods : their applicability is limited only to those words for which sense tagged data is available', 'SVM -LRB- Vapnik , 1995 -RRB- is a powerful machine learning algorithm for binary classification able to handle large numbers of parameters efficiently . low agreement on sense tagging', 'Two types of solutions have been proposed for the problem of low agreement on sense tagging', 'SVM -LRB- Vapnik , 1995 -RRB- is a powerful machine learning algorithm for binary classification able to handle large numbers of parameters efficiently . low agreement on sense tagging', 'The biggest limitation associated with this method is the need for large amounts of sense-tagged data', 'The proposed methods merge different senses by propagating seeds through these polysemous words in only one language side . we have been using the same set of features for all concepts']


Cluster  294
['The influence of the transseptal superior approach on the sinus node function in the mid-term postoperative period was apparently mild and did not cause a serious problem .', 'Pilonidal sinus is a common problem in the sacrococcygeal region, especially in obese, sedentary young men.', 'All lesions were located in the anterior lobe in the rostral vermis, the nodulus in the caudal vermis, or the tonsil.', 'The tonsil and the nodulus were considered to have a close relationship with the vestibular pathway.', 'The experimental group showed more improvements in the oral cavity, laryngeal elevation/epiglottic closure, residue in valleculae, and residue in pyriform sinuses of FDS and PAS compared to the control group (p\u200a<\u200a0.', 'Even though the treatment of arrhythmias is constantly developing , the maintenance of the sinus rhythm ( SR ) is still a serious problem .', 'The OptiScope laryngeal view grades of the glycopyrrolate group (grade 1\u200a=\u200a16 [41.', 'In the computer guided group, 3 out of 10 cases presented with sinus septa, only 1 case suffered from membrane perforation during the elevation process.', 'In this retrospective observational study, 240 sinus exposure CBCT records of 146 patients were evaluated.', 'The anatomical variation of the anterior superior alveolar nerve described as canalis sinuosus (CS) is a less known structure of anterior maxilla.', 'The oropharyngeal complications of IS therapy are seldom a serious problem .', 'For the 15 patients, the PSC-derived VA originated from the lower regions of the pulmonary sinuses, leading from the right, left, and anterior sinuses of the PSC in 4, 6, and 5 patients, respectively.']


Cluster  1796
['Interest has a precision of 95 % but a recall of only 23 % while money-fx has a precision of 89 % and a recall of 60 % . the SD scheme was developed against newswire data , namely the Wall Street Journal portion of the Penn Treebank', 'Interest has a precision of 95 % but a recall of only 23 % while money-fx has a precision of 89 % and a recall of 60 % . the SD scheme was developed against newswire data , namely the Wall Street Journal portion of the Penn Treebank', 'Interest has a precision of 95 % but a recall of only 23 % while money-fx has a precision of 89 % and a recall of 60 % . the SD scheme was developed against newswire data , namely the Wall Street Journal portion of the Penn Treebank']


Cluster  1682
['Drug shortages in developed countries pose a serious public health problem and have far-reaching implications for healthcare providers and their patients .', 'Although prohibited by law and legal regulatory frameworks , non-prescribed sale of antibiotics in community medicine retail outlets ( CMROs ) remains a serious problem in Ethiopia .', "Irrational use of medicines is a serious problem in China and has been the primary target of China 's national essential medicines programme ( NEMP ) .", 'Poor-quality medicines present a serious public health problem , particularly in emerging economies and developing countries , and may have a significant impact on the national clinical and economic burden .', 'In spite of being known as pharmacy of the third world , poor access to medicines in the country is always a serious concern .', 'Illicit sale of medicines is a serious public health problem in Africa .', 'Irrational , wasteful , and even dangerous medicine use is a serious problem in developing countries .', 'Poor quality antimalarials , including falsified , substandard , and degraded drugs , are a serious health concern in malaria-endemic countries .', 'Medicines are expensive and hard to access in Yemen , and counterfeit medicines are a serious problem .']


Cluster  1626
['A problem with the diagnosis of LOH is that often the symptoms ( in 20%-40 % of unselected men ) and low circulating T ( in 20 % of men > 70 years of age ) do not coincide in the same individual .', 'The L*-value was increased at 8 weeks (0.', 'To measure QOL before and after MMS and to identify risk factors associated with impaired QOL.', 'By using sequential 7-day Holter ECGs, LRAF between 3 and 12 months was observed in 48% and was associated with LAD (B = 1.', 'People with MHL showed a decrease in QoL, based on FHSQ scores, regardless of gender.', 'More than half of men and women aged ≥40 years in Taiwan are affected by LUTS, and these symptoms are often bothersome.', 'LAR is a serious problem in young patients ; however , its significance is still unappreciated .', 'The data of 60 male patients aged 39-78 years with single-segment central LSS were analyzed.']


Cluster  1522
['Grapevine yellows associated with phytoplasmas of the elm yellows group ( 16SrV ) , better known as flavescence dorée ( FD ) , is a serious quarantine problem in some important grapevine growing regions in the European Union .', 'The occurrence of Plasmopara viticola populations resistant to carboxylic acid amide ( CAA ) fungicides is becoming a serious problem in the control of grapevine downy mildew worldwide .', 'Viral diseases are a serious pathological problem for grapevines , and in recent years the need for increasingly specific and rapid diagnostic methods for the selection of propagation materials has grown .', "Pierce 's disease of grapevine ( PD ) , caused by the bacterial pathogen Xylella fastidiosa , remains a serious problem for grape production in California and elsewhere .", 'The increasing occurrence of QoI fungicide resistance in Plasmopara viticola ( Berk . & MA Curtis ) Berl . & DeToni populations is becoming a serious problem in the control of grapevine downy mildew .', 'The major problem with this approach is that grape pathogenesis-related proteins are highly protease resistant unless they are heat denatured in combination with enzymatic treatment .']


Cluster  1180
['Severe bacterial infections are a serious problem after cord blood transplantation ( CBT ) .', 'Although infection remains a serious problem in leukemia patients , considerable progress has been made .', 'Bacterial infections in patients with hematologic malignancies still represent a severe and life-treating problem .', 'We conducted a retrospective, observational study of patients with CRGNB bloodstream infections in our oncology and bone marrow transplant center.', 'Tuberculosis ( TB ) is a serious problem for patients undergoing haematopoietic stem cell transplantation ( HSCT ) in TB-endemic areas ; however , data on these patients are limited .', 'Our study did not find CCT superior to colistin monotherapy in patients with CRGNB blood stream infections; except in the subgroup of neutropenic patients with Enterobacteriaceae bloodstream infections, where combination therapy performed better.', 'However , delayed engraftment , prolonged neutropenia , secondary graft loss , and graft-versus-host disease ( GVHD ) in recipients of cord blood transplantation ( CBT ) make opportunistic infections a serious concern .', 'Infections continue to be a serious problem for severely neutropenic oncology and haematopoietic progenitor cell ( HPC ) transplant patients .', 'To analyze the characteristics of bloodstream infections in hematopoietic stem cell transplant recipients.']


Cluster  184
['However , we see the following as well . word vectors developed from distributional models cannot reveal word relatedness if its information does not lie in word distributions', 'Content determination in the systems examined basically performs two functions : Deep content determination : Determine what information should be communicated to the hearer . the metric used to measure the similarity between strings ( n-gram overlap ) is only a crude approximation of an ideal semantic similarity metric', 'The limitation is that word vectors developed from distributional models cannot reveal word relatedness if its information does not lie in word distributions', 'Another limitation of the current implementation is the limited scope of the similarity function', 'The algorithm is empirically evaluated on two tasks , solving multiple-choice SAT word analogy questions and classifying semantic relations in noun-modifier pairs . its restricted range of syntactic coverage', 'The algorithm is empirically evaluated on two tasks , solving multiple-choice SAT word analogy questions and classifying semantic relations in noun-modifier pairs . its restricted range of syntactic coverage', 'There are two main ( not unrelated ) disadvantages to word similarity based approaches : 1. word co-occurrence information is not sufficiently exploited', 'A second limitation of the approach presented in this paper is that the metric used to measure the similarity between strings ( n-gram overlap ) is only a crude approximation of an ideal semantic similarity metric', 'We rather use the ubuntu-users email archive11 as our primary corpus . the limited scope of the similarity function']


Cluster  1493
['Mycobacterium ulcerans causes chronic nectotizing ulcers of the skin and subcutaneous tissue and is a serious health problem in some tropical countries .', 'Buruli ulcer (BU), caused by Mycobacterium ulcerans, is increasing in incidence in Victoria, Australia.', 'Mycobacterial disease remains a serious global health problem .', 'Mycobacterial disease remains a serious international public health concern .', 'Nontuberculous mycobacterium ( NTM ) infection in a patient in an immunosuppressed state caused by increased use of immunosuppressive or biological agents is a serious clinical problem .']


Cluster  933
['The evidence that most histographic analysis parameters had excellent reliability for both T1- and T2-weighted images allows for cross-reference of the results between the two kinds of image.', 'The Catcher Tagged method is very useful for accurate one-to-one correspondence locations and pathological evaluation, and easy-to-retrieve multiple resected specimens.', 'The lack of definitive criteria for distinguishing metastatic from benign nodes is a serious shortcoming of current imaging options .', 'The HS lesion count tool had an acceptable inter- and intrarater reliability, indicating that HiSCR has a strong degree of reproducibility and consistency in the evaluation of patients with HS.', 'The problem with magnetic resonance imaging was believed to be that it could not completely differentiate fibrosis from viable residual tumors .', 'The problem of diagnosis with traditional methods is that they have a low sensitivity or time consuming but molecular techniques would be an alternative method for rapid and accurate diagnosis .', 'A serious problem for every pathologist is how to avoid making errors in histopathological diagnosis .', 'Conversely , a drawback of PET and SPECT was the partial volume effect and these methods could visualize the lesions as only diffuse decrements of attenuation and could not provide detailed information .', 'A significant drawback of this approach , however , is the potential loss of important histological information , such as risk of lymph node metastasis , depth of tumor penetration , and presence of lymphatic or vascular invasion .', 'The most classical and reliable technique is the surgical biopsy with prior marking using a metallic harpoon , but , besides its high cost , it has the drawback of being an aggressive technique for the diagnosis of a benign pathology .', 'A possible drawback of the axial approach is increased histopathology slides .', 'A drawback of the SPECT method is its limited sensitivity in detecting small meningiomas .', 'A practical drawback of this approach is the limited availability of autologous tumor samples .', 'It may be useful in the detection of synchronous tumors , which are a serious problem in head and neck cancers .', 'One of the major problem with existing histological classifications is that there is no consensus on the implementation of biopsy in the treatment of HSPN .', 'The main problem with early detection was that a background of uneven Thorotrast deposits visualized in the liver disguised the tumor as Thorotrast granulations .']


Cluster  1821
['These events are experienced by 91 % of home support workers and range from a serious medical incident ( e.g. , fall , death ) to an interpersonal dilemma ( e.g. , client refusal of service , argument between worker and family member ) .', 'CBT alone or with trained peer facilitation with homecare workers can increase confidence and reduce incidents of workplace violence and harassment in a consumer-driven model of care.', 'Homecare workers reported improved confidence to prevent and respond to workplace violence and harassment and a reduction in incidents of workplace violence and harassment in both groups at 6-month follow-up.']


Cluster  510
['Threats from chemical warfare agents , commonly known as nerve gases , constitute a serious security issue of increasing global concern because of surging terrorist activity worldwide .', 'Threats of chemical and biological warfare agents ( CBWA ) represent a serious global concern and require rapid and efficient neutralization methods .', 'The contamination of the environment with explosive residues presents a serious ecological problem at sites across the world , with the highly toxic compound trinitrotoluene ( TNT ) the most widespread contaminant .', 'Exposure to organophosphorus ( OP ) pesticides represents a severe health issue in developing countries , while OP intoxication with the more lethal military nerve agents is not only of military concern but also a terrorist threat .', 'The contamination of the environment with explosive residues presents a serious problem at sites across the world , with the highly toxic compound TNT being the most widespread explosive contaminant .', 'Organophosphorus compounds have been widely employed to the development of warfare nerve agents and pesticides , resulting in a huge number of people intoxicated annually , being a serious problem of public health .']


Cluster  1117
['Our present understanding of G protection suggests that the elimination of LOC as a serious problem for USAF high-performance aircraft operations must include the supination of aircrew to a minimum seat back angle of 60 degrees to 65 degrees .', 'High-acceleration loss of consciousness is a serious problem for military pilots .', 'It is recognised that back pain ( BP ) is a debilitating medical problem in the soldier community , which limits operational readiness as well as work ability .', 'Back disorders have long been recognized as a serious problem within the military aviation community and a possible threat to mission accomplishment .', 'Neck and back pain in fighter pilots remains a serious occupational problem .']


Cluster  1806
['The secondary tags are not predicate-specific in the sense that they are not required by this particular predicate and they are not selective with regard to the predicate they can occur with . complicating the feature space', 'The secondary tags are not predicate-specific in the sense that they are not required by this particular predicate and they are not selective with regard to the predicate they can occur with . complicating the feature space']


Cluster  1616
['Million tons of sewage sludge produced yearly creates a severe pollution problem to environment , and thus needs either to be properly disposed of , or recovered .', 'Sewage sludge is a serious problem due to the high treatment costs and the risks to environment and human health .', 'Therefore , this by-product of activated sludge process ( ASP ) presents a serious environmental problem .', 'Sewage sludge is a serious problem facing modern wastewater treatment plants .', 'As a result of the wide application and utilization of the waste activated sludge process , excess sludge presents a serious disposal problem .', 'Disposal of tons of sludge produced daily by sewage treatment plants in large cities is a serious problem .', 'Removal of sludges from Wastewater Treatment Plants ( WWTP ) represents a serious worldwide environmental problem for which alternatives other than their simple incineration are investigated .', 'The huge volume of sludge emanating from the tannery effluent treatment plants poses a serious environmental problem .', 'Ultimate disposal of the sludge or the adsorbate , however , is a serious problem .', 'Even though treated effluent water from wastewater treatment plants are utilized for irrigation , disposal of sewage sludge is becoming a serious problem .']


Cluster  1200
['The special part among the risk factors plays the low physical activity , which , due to rapid development of civilization , makes a serious problem concerning mainly the well-developed countries .', 'Physical activity confers numerous health benefits, yet few adults meet recommended physical activity guidelines.', 'Sedentary behaviour in children is related to different health consequences such as overweight and cardio-metabolic diseases that can track into adulthood', 'Physical inactivity among children is a serious public health problem .', 'Physical inactivity is the fourth leading risk factor for mortality worldwide and a leading risk factor for type 2 diabetes and cardiovascular disease.', 'Lack of physical activity among American adults is a serious public health concern .', 'Physical inactivity was considered a serious public health concern by 55 % of the respondents ; similar to unhealthy diets ( 58 % ) and tobacco use ( 57 % ) .', 'A physical activity transition to declining activity levels , even among children , now poses a serious public health concern because of its contribution to a rising prevalence of noncommunicable diseases .', 'Insufficient activity is a serious health concern among university students .', 'On the other hand , sedentary behavior has reached alarming levels among the general population , which qualifies it as a serious health problem of endemic proportions .', 'Physical inactivity is a significant problem among medical undergraduates.', 'An increase in the physical activity of individuals has many health benefits , but a drawback of an increase in physical activity is the risk of related injuries .', 'The combination of the health risks associated with physical inactivity and obesity presents a serious health concern in this population .', "Sedentary life has been recognized as a serious problem in today 's Iranian society ."]


Cluster  1781
['To determine the long-term efficacy of adalimumab in patients with psoriasis with flexibility to escalate and de-escalate between EOW and EW dosing.', "To investigate the pattern of psoriasis recurrence in patients who were treated with brodalumab following Amgen's decision to stop the clinical programme in June 2015.", 'Abrupt cessation of brodalumab is associated with a rapid relapse of psoriasis with some patients experiencing a rebound.', 'Previous studies of long-term drug survival in patients with psoriasis vulgaris showed significantly higher drug survival for ustekinumab than infliximab, and adalimumab.', 'To characterise population pharmacokinetics of adalimumab 40 mg every other week dosing regimen and impact of immunogenicity on pharmacokinetics, efficacy and safety in psoriasis patients.', 'Data from an open-label study in patients with psoriasis who had received adalimumab in phase 2/3 studies and their extensions were included.', 'We retrieved data on all patients treated with biological agents and calculated the long-term drug survival for infliximab, adalimumab, and ustekinumab using our psoriasis registry (Kurume Psoriasis Registry: KURUPR) consisted of 343 patients by the end of March 2017.']


Cluster  149
['Fair individuals spent less time in the sun than non-fair individuals, but a greater proportion of time using sun protection behaviors, including sunscreen with SPF 30+ (odds ratio (OR)\xa0=\xa01.', 'Visual imagery has been shown to improve adherence to health messages but has scarcely been investigated in sun protection campaigns.', 'The attitude and knowledge of sun protection to prevent adverse events were significantly different among the group of educational levels and previous history of laser treatment.', 'One hundred and forty-five participants received standard of care (SOC) as defined as sun protective counseling and were then randomized to receive either (a) images of sun damage, (b) a textual pamphlet about sun damage, or (c) no further messages.', 'Sunscreen efficacy is usually expressed by the sun protection factor (SPF) which is calculated by establishing the minimum erythematous dose (MED), i.e. the smallest amount of energy required to trigger erythema.', 'Appearance-based photos of sun damage were more effective than health-based messages among Hispanics, younger patient populations, and those who find tanned appearances to be attractive.', 'Fair individuals spent less time in the sun and practiced more sun protective behaviors than non-fair individuals.', 'Both pictorial and textual stimuli were more effective than SOC in improving intentions to sun protect, but there was no differential effect between the two.', 'Appearance-based interventions were more effective in improving intentions to sun protect among both Hispanics and non-Hispanic Whites (P\xa0<\xa00.', 'Standardized sunscreen application followed by digital photography and indirect computer-based colorimetry represents a potential method to objectively quantify visibility of sunscreen on the skin.', 'It is necessary to develop photoprotection campaigns aimed at beachgoers, particularly in young people, men, those with skin phototypes I-III and secondary or university education.', 'A cross-sectional health survey was conducted at the beach during the summer.']


Cluster  275
['The occurrence of bleeding in trauma patients is a life-threatening problem which can be explained by different mechanisms .', 'Hemorrhage of the upper gastrointestinal tract ( UGI ) remains a serious clinical problem .', 'Although colonic diverticular bleeding (CDB) often ceases spontaneously, re-bleeding occurs in about 30%.', 'Massive bleeding that can not be controlled by the usual means , such as transfusion , is a serious medical problem with high associated mortality .', 'Gastrointestinal bleeding ( GIB ) is a life-threatening problem that requires a multidisciplinary approach for successful treatment .', 'Severe and intractable gastrointestinal bleeding caused by angiodysplasia is a debilitating problem for up to 20 % of patients with von Willebrand disease ( VWD ) .', 'There are still situations in surgery when diffuse bleeding becomes a severe problem .', 'Although most commonly performed portal decompressive procedures control bleeding effectively , postoperative morbidity and mortality remains a serious problem in these patients .', 'Endoscopic variceal ligation (EVL) plus beta blocker is the mainstay treatment after index bleed to prevent rebleed.', 'Bleeding secondary to severe vesicoprostatic pathology ( mainly neoplasic disease and radiation cystitis ) may be a serious clinical management problem due to its morbidity and associated increased resources demand in the form of admissions , transfusions and other measures .', 'In our experience, indirect electrocoagulation via a fragment of the rectus abdominis muscle of the abdomen is a rapid, easily executed and effective method for controlling presacral venous bleeding during rectal resection.', 'Gastrointestinal haemorrhage ( GI ) is a serious condition that presents both diagnostic as well as therapeutic challenges .', 'Gastrointestinal ( GI ) tract bleeding of unknown origin is a vexing clinical problem .', 'A serious problem was uncontrollable bleeding from the cannulation wounds with a rapidly declining PCV .']


Cluster  119
['Self-injurious behaviour ( SIB ) is a devastating problem observed in individuals with various neurodevelopmental disorders , including specific genetic syndromes as well as idiopathic intellectual and developmental disability .', 'Patients with a higher level of negative symptoms displayed significantly fewer prosocial (e.g., nodding and smiling), gesture, and displacement behaviours (e.g., fumbling), but significantly more flight behaviours (e.g., looking away, freezing).', 'Self-injurious behavior ( SIB ) remains a severe and intractable abnormal behavior for nonhuman primates in diverse settings and is a significant concern for veterinarians and behavioral scientists .', 'Self-injurious behavior is a serious problem that is not uncommon among individuals with mental retardation .', "Patients' attention-seeking actions varied in content, form and the types of responses they elicited.", 'We found a total of 66 situations in which patients attempted to attract the attention of others on their own initiative in order to express themselves.', 'Negative symptoms are associated with both a lower level of actively engaging non-verbal behaviour and an increased active avoidance of social contact.']


Cluster  478
['A drawback of sfMRI is that it requires long acquisition times ( 30 - 40 min ) to achieve statistically significant activation .', 'As the best extractant among the investigated ones , D3EI-PrCl ( with straight alkyl chain at substituent ) can be pointed out , however , problems with effective stripping or phase disengagement after stripping should be indicated as a drawback of the organic phases used .', 'It would also seem that there is some competition amongst different compounds for sites on the fibre and this is a potential drawback of SPME when applied to unknown samples .', 'However , one limitation with UMAP and t-SNE is that they can only capture the local structure of the data , the global structure of the data is not faithfully preserved .', 'The problem with the ASE and MSE is that both depend on the choice of the reference systems while NICS , which avoids the need for reference molecules , is impossible to vary experimentally .', 'A drawback of direct extraction was the small fragment size of approx 12 kb .']


Cluster  1794
['Intractable aspiration is a life-threatening problem and often requires a procedure for blocking or separating the larynx from the bronchial tree .', 'Intractable aspiration may be a life-threatening problem for patients with altered laryngeal function secondary to neurologic disorders or abnormal laryngeal anatomy .', 'Intractable aspiration is a life-threatening medical problem .', 'Aspiration ( the entry of foreign contents into the upper airway ) is a serious concern for individuals with dysphagia and can lead to pneumonia .', 'Aspiration was diagnosed in 25\xa0patients (17.', 'Aspiration caused by unilateral combined laryngeal and pharyngeal paralysis is a serious clinical problem .', 'Aspiration is a serious clinical concern in patients with long-term artificial airways .', 'Aspiration pneumonia is a serious problem among elderly patients ; it is caused by many risk factors including dysphagia , poor oral hygiene , malnutrition , and sedative medications .', 'Aspiration pneumonia is a serious health concern in older patients with schizophrenia .']


Cluster  447
['EA may modulate reproductive hormone levels and the effects seem to persist for at least 12\u2005weeks after treatment with no significant side effects.', 'GnRH agonist triggering with exclusive hCG support may be a valid alternative to hCG triggering with progesterone support.', 'To carry out a prospective observational study aimed at assessing the effect of EA on the reproductive hormone levels of patients with DOR seeking fertility support and consider its safety.', 'Luteal phase physiology is distorted by in vitro fertilization (IVF) cycles using gonadotropin-releasing hormone (GnRH) agonists and antagonists, Controlled ovarian hyperstimulation leads to luteal phase defect and for this reason, luteal phase support is now an integral part of IVF/ICSI-ET programs.', 'Our study indicates that Dienogest is a suitable and safe substitute for GnRHa pretreatment in endometriosis patients.', 'Gonadotropin releasing hormone (GnRH) agonist triggering results in an endogenous gonadotropin flare.', 'Clinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve.', 'The patient who has gonadotrophin-resistant ovaries and who requires ovulation induction or superovulation for IVF presents a serious problem .', 'No significant difference was observed in the reproductive outcomes between the groups; thus, there appears no requirement to delay the withdrawal of the catheter to improve the outcomes in ICSI cycles.', 'No significant difference was found for the number of oocytes, oocyte maturation rate, fertilization and implantation rate, clinical pregnancy rate (25 vs.', 'Although there was no statistically significant difference between both groups regarding ovarian stimulation, response parameters, and pregnancy outcomes, the Dienogest group had a lower cost of treatment (2773 vs.', 'The problem with this " gold standard " is that it builds on the misconception that fertility peaks with ovulation and that ovulation regularly occurs 24 to 48 hours after the LH surge .', 'The problem with applying information on progestogen potency obtained from biologic testing to clinical prescribing practices is that the changes in potency relate to more than progestogen dosage .']


Cluster  597
['118 infants (pre-TH: n = 44, TH: n = 74) were assessed.', 'One hundred fifty cases of premature infants were divided into three groups.', 'Forty-eight neonates were evaluated with 16 in each of three groups.', '413 infants were assigned between Test (n = 206) and Control (n = 207) formula.', 'Twenty children were analyzed with age range of 5\xa0days to 11\xa0years, ASA 1-4, and weight range 3-57\xa0kg.', '100 infants were included with complete follow-up data on 87 (87% response rate).', 'This study aimed to test the applicability and effectiveness of the enhanced informed consent form (ICF) methodology, proposed by the Strategic Initiative for Developing Capacity in Ethical Review (SIDCER), in neonatal research requiring maternal consent.', 'Only 61 children of 168 were recruited before stopping this study because of severe adverse events (n = 4) or parental requests for discontinuation due to discomfort to their child during nebulization (n = 2).', '29 former term infants and 79 former VPI were included in the study.', 'Infants from SKOT-I (n = 273) and SKOT-II (n = 132) were examined including anthropometric measurements and blood samples analyzed for glucose, insulin, insulin-like growth factor-I (IGF-I), adiponectin, and leptin.', 'A total of 146 (80%) infants were included in the intention-to-treat analysis at 6 mo.', 'From a total population of 200 enrolled infants 22.', 'The studied infants were divided into five groups.']


Cluster  1700
['To examine the effects of two sustained propped slouched sitting (PSS) postures on spinal height after a period of trunk loading.', 'Experimental groups showed better scores at discharge at Trunk impairment Scale (p\u200a<\u200a0.', 'Exercise improved the performance of the trunk muscles despite no impact on CSA.', 'The use of the brace corrects the function of the trunk and has a positive influence on its perception.', 'Both PSS with and without lumbar support significantly increased spinal height after a period of trunk loading (p\xa0<\xa00.', 'ES in a sitting position is a potentially effective and accessible rehabilitation treatment, which can lead to short-term improvement in the extensor trunk muscle strength of the lumbar paraspinal muscles.', 'The schoolchildren in the cushion group performed better at the trunk repositioning task (p= 0.', 'BBAT as an additive to bracing and TEs improve curve magnitude, body symmetry and trunk deformity.', 'Trunk impairment at admission assessed by FACT could predict functional prognosis.', 'To explore the effects of an exercise intervention on the size and exercise performance of the lumbar spine extensor muscles.']


Cluster  1418
['Concomitant neurologic manifestations and positive antiphospholipid antibodies (APAs) have been investigated in different manners.', 'Anti-DI antibody positivity can be considered a new risk factor predictive of the first thrombotic event in aPL carriers, instead, negative anti-DI may be useful to identify low-risk aPL carriers.', 'This cross-sectional descriptive study was conducted on 100 consecutive patients with selected neurological manifestations and at least one positive APAs within the age range of 20-50 years, referred to the Rheumatic Diseases Research Center from the Northeast Central Neurology Department of Iran during August 2012 to March 2014.', 'The findings of this study revealed some associations between the subtypes of APAs and incidence of neurologic disorders.', 'Renal involvement can be a serious problem for patients with antiphospholipid syndrome ( APS ) .', 'Anti-DI antibodies were detected in 44 aPL carriers (41.', 'According to the results, 89% of the participants were persistently positive for APAs, including lupus anticoagulant, IgG anticardiolipin (aCL), IgM aCL, IgG β-2 glycoprotein 1 (β2- GP1), and IgM β2-GP1, observed in 16%, 41%, 42%, 17%, and 15% of the patients, respectively.']


Cluster  866
['Although AFMs have high ( nanoscale ) spatial resolution , a problem with current AFM systems is that they have low temporal resolution , i.e. , AFM imaging is slow .', 'Almost perfect image quality is achievable with incremental PD imaging , which represents a compromise for MRCF with the drawback of prolonged scanning time .', 'Historically , a major drawback of scanning probe lithography has been the intrinsically low throughput of single probe systems .', 'A drawback of light microscopy is the fundamental limit of the attainable spatial resolution -- approximately 250 nm -- dictated by the laws of diffraction .', 'A major drawback of MLA based light field cameras is low spatial resolution , which is due to the fact that a single image sensor is shared to capture both spatial and angular information .', 'However , a drawback of hopping/backstep mode of SICM is its relatively slow imaging speed , which seriously restricts the study on the dynamic process of biological samples .', 'Although paraCEST is a method with immense scope for generating image contrast in MRI , it suffers from the serious drawback of high detection limits .', 'Zernike phase contrast transmission electron microscopy can improve contrast , and can also fix a fatal problem related to the inherent low contrast of conventional electron microscopy , namely , image modulation due to the unavoidable setting of deep defocus .', 'A problem with these high-keV images is that contrast enhancement provided by all commercially available contrast media is severely reduced .']


Cluster  2343
['To understand how nursing students at the end of their nursing education view nursing care.', 'Deans of nursing are challenged with multiple expectations of their role, which is unlike that of other deans in academia', "A nursing student's first placement is a significant and influential experience that can be a factor in attrition from nursing education programs", "According to our results, establishing specific academic plans for students in higher years (3rd and 4th) could improve nursing students' satisfaction with their clinical practice.", 'There is a need for nursing educators to implement HFS in nursing curricula, where its integration can bridge the gap between theoretical knowledge and nursing practice and enhance critical thinking and motivation among nursing students.', 'Attrition from nursing programmes is a serious problem in the UK .', 'To describe how nursing students perceive the different components of the nursing role at the beginning of the nursing degree.', "Finding the right method to influence student engagement with research can provide a unique opportunity to positively affect students' perceptions of nursing research", 'Evidence demonstrates there is a need for innovation and further investigation on how to best prepare nursing students for practice', 'This article highlights the contributions made by historically Black colleges and universities (HBCUs) to the nursing profession, as well as the challenges faced by HBCUs as they make these important contributions', 'Nurse education needs to be improved both theoretically and during clinical placements in order to advance and sustain compliance among student nurses.', 'The dissonance experienced between nurse educators and millennial students is a well-known phenomenon, yet evidence ascertaining what these learners seek to actively engage in meaningful learning is scant']


Cluster  1650
['A 54-year-old profoundly mentally retarded female patient with phenylketonuria and a severe behaviour problem was treated with a restricted protein and high energy diet .', 'Rehabilitating a child with a severe feeding problem .', 'The cachexia-anorexia syndrome , in which patients suffering from chronic illness lack the desire to eat and experience weight loss , creates a serious clinical problem when patients are attempting to overcome the disease process .', 'Cachexia can be a severe problem in the management of patients with cancer and other illnesses because it produces an ever-increasing spiral of anorexia , undernutrition , loss of tissue mass , muscle wasting , and increased susceptibility to infection and treatment toxicity .', 'She ate large amounts of food and her overweight became a serious problem in her care at home .']


Cluster  467
['Sexual aggression ( SA ) is a serious public-health problem on college campuses , and there is a pressing need for basic research fostering the development of novel prevention strategies .', 'A serious concern is the disparity between the number of those who met the behavioral criteria for rape victimization based on the current legal definition , but who', 'Date rape ( DR ) is a serious but under-recognized public health problem that affects female university undergraduates .', 'Campus sexual assault is a long-standing challenge and continues to be a severe problem for American higher education .', 'We included 98 male patients aged 15 years and older (range 15-66, median 25) at the time of a reported sexual assault.', 'Sexual aggression is a serious societal problem , yet treatments for sexual aggressors have generally been ineffective in part because of the lack of unified theories to guide treatment .', 'The proposed approach is empirically tested using real data from a national survey of inmate sexual abuse where measurement errors are a serious concern .', 'Alcohol-facilitated sexual assault is a serious problem on college campuses , and bystander intervention has been shown to be a successful method in reducing sexual assaults .', 'Sexual assault is a serious problem on college campuses .']


Cluster  665
['Vaginal bleeding in a prepubertal child is always a serious medical concern .', "The restriction in the practice of episiotomy and the use of active management can therefore be established as key measures that professionals can modify in order to reduce blood loss during precipitate labour and to improve these mothers' postpartum period.", 'Episiotomy is related to greater reduction of haemoglobin concentration in comparison with all degrees of spontaneous perineal trauma.', 'Menorrhagia was a serious problem necessitating repeated transfusions and hormonal therapy .', 'Postpartum hemorrhage ( PPH ) represents a serious problem for women and obstetricians .', 'When it is compounded by a life-threatening complication , such as uncontrollable hemorrhage , it challenges the skills of the most experienced obstetrician and the resources of the best-equipped facility and its personnel .', 'To assess the relationship between the degree of perineal trauma and change in haemoglobin concentration at vaginal birth.', 'Precipitate labour is related to the appearance of postpartum haemorrhage due to posterior uterine atony.', 'Severe postpartum haemorrhage ( PPH ) is a serious clinical problem that is increasing in incidence .', 'An overriding consideration in the decision to treat any of these problems during the neonatal period is the risk of major blood loss , which can pose a life-threatening problem .']


Cluster  1759
['Understanding actual processes that nurses follow is critical to guide improvement efforts and to develop robust systems to ensure safety in medication administration.', 'To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors.', 'Nurses followed a common work process to administer medication.', 'To understand the medication administration process in residential aged care homes.', 'A non-participant observational study was undertaken of nurses conducting medication rounds.', 'This study elaborated the medication administration process in a residential aged care home and identified process deviations.', 'Seven nurses were observed for 12 morning medication rounds at two units of a residential aged care home in Australia.', "Factors that contributed to the observed complexity of medication administration in nursing homes were the high number of single tasks, varying degree of linearity, the variability of technological solutions, demands regarding documentation and staff's apparent freedom as to how and where to perform medication-related activities."]


Cluster  365
['Although the exact diagnostic boundaries for social phobia are difficult to determine , it can be concluded that social anxiety is a distressing problem for a considerable proportion of the general population .', 'The study provides a deeper insight into a vulnerable group with substantial challenges related to adverse social experiences, psychological distress, and alcohol use, who emphasized relational problems as the main causal factor for their illness.', "It can become a serious problem affecting individuals ' social communication and self-confidence .", 'This means a severe problem in communication .', 'However , Personal and Social Functioning highlights , in about 1/3 of cases , relevant or serious problems mainly in Work and Relationships areas , whilst Aggressiveness is a serious problem only in 9 % .', 'Thus , there seems to be a severe disconnect between the frequency of the problem and the amount of attention devoted to it .', 'We have become concerned about a group of people who have the potential to live largely independently ( or semi-independently ) , to work at meaningful jobs in the community , and to make full use of the same recreational and leisure opportunities as other members of society but who are prevented from doing so because of a life-threatening behavior problem .', 'A serious problem is a high rate of non-responders , between 15 and 50 % according to the literature .', 'Besides , somnolence in many other practical situations was more often considered as a serious problem in the group A.', 'Social pain is considered a feature of humanity', 'However , participants who perceived problem gambling as a dangerous condition wanted more social distance than those who did not perceive individuals with a gambling problem as dangerous .', 'While all of these provide some rationale for eschewing aggression research , aggression remains a serious social , economic , health , and political problem .', 'A major problem with the evidence is that aggression is frequently reported only as one of the items contributing to the total score on a scale or a subscale .']


Cluster  1353
['The aim of the study was to determine the frequency and reasons for donor deferral prior to the blood donation process in our population.', 'To assess the awareness and attitudes related to blood transfusion safety among blood donors from the Autonomous Province (AP) Vojvodina, Republic of Serbia.', 'This study aimed to analyse motivational factors for blood donation in different donor groups.', 'Male blood donors, the youngest\u2009age\u2009group\u2009(18-20 years), those who donate blood for the first time and those with a\u2009lower educational level showed the lowest awareness of, and the most negative attitudes about, blood safety.', 'During a 12-month period, every sixth blood donor presenting at the blood donation centre of the University Hospital was asked to complete a self-administered questionnaire assessing motivational factors for blood donation.', 'The present study aimed to determine major factors that influence blood donation in China.', 'Identification of motivational factors can lead to the design of targeted motivation campaigns for blood donation.']


Cluster  2237
['Methamphetamine dependence is a serious health problem among Iranian methadone patients .', 'Methamphetamine ( METH ) dependence , especially among women , is a serious global health problem .', 'Methamphetamine addiction is a serious public health problem in those countries .', 'The production and use of the highly addictive stimulant methamphetamine are a serious public health problem in the United States and globally .', 'Methamphetamine ( METH ) use and dependence is a serious public health concern with implications across multiple areas from societal impact to burden on psychiatric and medical resources .', 'Methamphetamine is a serious illicit drug problem in the United States and globally .', 'Methamphetamine ( METH ) , a substance with a high potential for abuse and addiction , is a serious worldwide public health problem .', 'Methamphetamine abuse and dependence , frequently accompanied by schizophrenia-like psychotic symptoms [ methamphetamine-associated psychosis ( MAP ) ] , is a serious public health problem worldwide .', 'Methamphetamine use has become a serious problem in Cape Town , particularly among adolescents .', 'Although methamphetamine use is a serious public health concern , only a few studies have examined HIV testing among young drug users .', 'Methamphetamine ( METH ) abuse has been a serious global public health problem for decades .', 'Methamphetamine addiction is a serious worldwide public health problem with many consequences and complications .', 'Methamphetamine abuse has become a serious public health problem .']


Cluster  1050
['16 (8.', 'At the three time points, 70 (93.', 'We conducted 16 sessions of Hatha yoga over 8 weeks.', 'A total of 120\xa0hr of observation were undertaken.', 'Average BW (62.', 'The average daily time dedicated to these activities was 92.', 'A total of 210 construction workers (8.']


Cluster  1024
['Aspirin-exacerbated respiratory disease (AERD) is a disorder of nasal polyposis, asthma, and hypersensitivity respiratory reactions when on systemic cyclooxygenase 1 blockade', 'Mild (n\xa0=\xa041) or moderate-to-severe (19) asthmatics and 27 normal controls were examined for pulmonary function (FEV<sub>1</sub> and mid-forced expiratory flow), sputum cell differentials, and sputum levels of prostaglandins D<sub>2</sub>, E<sub>2</sub>, F<sub>2α</sub>, and thromboxane B<sub>2</sub> measured by sandwich enzyme immunoassay.', 'An imbalance in production, breakdown, or both between prostaglandin E<sub>2</sub> and other prostanoids possibly due to epithelial damage may be involved in the pathogenesis of moderate-to-severe asthma.', 'Genotyping and imputation was performed in fluticasone furoate (FF) or fluticasone propionate-treated patients with asthma from 3 phase IIB and 4 phase IIIA randomized, double-blind, placebo-controlled, parallel group, multicenter studies.', 'Treatment of inflammatory diseases of asthmatics can be a serious problem since some patients show intolerance to aspirin and other non-steroidal , anti-inflammatory drugs that are cyclooxygenase inhibitors .', 'To assess whether type 2 inflammation is associated with an increased risk of virus-induced exacerbations of asthma.', 'Stable asthmatics had spirometry, skin prick test, measurement of FeNO and sputum induced for differential cell counts.', 'Local anaesthetic allergy does not seem to be a serious problem among asthmatic children and testing in all asthmatic children is not warranted .', 'Allergy and/or contraindications for theophylline and adrenergic drugs can be a life-threatening problem for patients with respiratory failure resulting from status asthmaticus .']


Cluster  918
['One major problem encountered with cereal anther culture is that some genotypes are low or non-responders to the technique .', 'Improving yield and yield-related traits is the crucial\xa0goal in breeding programmes of cereals', 'The results provide reliable GI and GL values for 17 common date varieties in Saudi Arabia.', 'The occurrence of speltoid aberrants in wheat breeding is a serious problem that may result in rejection of a candidate cultivar during licensing .', 'However , the low percentage fruit-set associated with large size did not present a serious problem since the total estimated seed production per plant still increased with size .']


Cluster  2018
['We also conducted an experiment using real-world customer-care related questions . data sparseness for PCFG', 'We also conducted an experiment using real-world customer-care related questions . data sparseness for PCFG']


Cluster  1564
['Wise pattern mammoplasty group had statistically significant higher complication rate.', 'We retrospectively reviewed 172 consecutive breast cancer patients treated in our center.', 'In total, 72 patients undergoing breast cancer surgery were randomly divided into an intervention group and a control group; each group contained 36 subjects.', 'A total of 129 women treated for breast cancer reporting persistent pain were randomized to MBCT or a wait-list control.', 'Breast cancer survivors (N=51) were randomly assigned to the intervention or control group.', 'The use of the MammaPrint<sup>®</sup> assay was a decisive factor for the recommendation of adjuvant treatment with chemotherapy and/or hormone therapy in patients with high risk for relapse.', 'Postmenopausal women with HER2-negative, hormone receptor-positive tumors and persisting circulating tumor cells (CTCs; assessed using the FDA-approved CellSearch® System, Janssen Diagnostics, LLC) after chemotherapy were randomized to 2 years of tamoxifen followed by 3 years of exemestane (tamoxifen-exemestane group, n = 54) or 5 years of exemestane (exemestane-only group, n = 54).', 'Comparison between mammary Paget and extramammary Paget disease showed no significant differences in the features studied.', 'We conducted an observational retrospective study including 598 patients with clinically T1-T3 and node negative invasive breast cancer.', 'Patients with locally advanced/metastatic breast cancer who had not received any prior chemotherapy or hormone therapy were included.', 'Between 1975 and 1978, 327 patients with primary breast cancer were randomly assigned to two years of daily placebo or tamoxifen.', 'Disparities in access to care exist for breast cancer patients, including access to surgeons performing reconstruction.', 'This retrospective observational study was conducted in a French comprehensive cancer center where patients treated for breast cancer with primary surgery were prospectively included between 2010 and 2016.', 'This is a retrospective observational study including 126 breast cancer patients who presented between 2009 and 2015 to the National Cancer Institute of Cairo University in Egypt.']


Cluster  1478
['The solvent-extracted wool wax was found to have a significantly higher polar lipid content than that of the water-extracted wool wax.', 'The suitability of the solvent-extracted wool wax for application in the preparation of cosmetics and dermatological products was demonstrated.', 'Wool wax is a soft, yellow, waxy substance that is secreted by the sebaceous glands of sheep.']


Cluster  1647
['All eyes showed a central area of hypoautofluorescence at the macula along with retinal flecks extending centrifugally as well as to the nasal side of the optic disc.', 'In an experimental double-masked clinical trial, right eyes of 24 albino rabbits were chemically injured by 1\xa0N NaOH.', 'Treatment and rehabilitation of patients with destructive lesions of the cornea is a serious problem for ophthalmologists due to severity of the outcome of the disease - the formation of leukomas with a persistent decrease in vision , or even a complete loss of visual functions .', 'Open globe injuries remain a serious public health problem , resulting in significant vision loss .', 'The ocular tissues were not significantly disturbed and hemorrhage was not a serious problem .', 'When cortical blindness occurs , it is a serious clinical problem whether transient or permanent .', "The following objective parameters improved significantly from day 1 to week 6 in patients treated with phosphate-free high molecular weight hyaluronate: visual acuity, conjunctival hyperaemia, conjunctival chemosis, corneal fluorescein-staining, corneal endothelial-epithelial decompensation, Descemet's folds, the maximum diameter of corneal erosion, Tyndall effect and cells in the anterior chamber.", 'Damage to the cornea from chemical burns is a serious clinical problem that often leads to permanent visual impairment .', 'Corneal NV , whatever the cause , impairs vision and threatens the survival of corneal allografts , thus representing a serious clinical problem for which treatment is limited .', 'Acute vision loss is a devastating problem for patients and a challenging diagnostic dilemma for Emergency Physicians .', 'Vision loss following eye trauma is a serious health problem worldwide .', 'The main problem with using enucleated animal eyes in surgical training is that they remain fresh for such a short time .']


Cluster  2110
['Topical capsaicin 8% pretreatment for 24 h reduced histaminergic and nonhistaminergic itch by about 75%, while a significant reduction (≈60%) was achieved for only nonhistaminergic itch in a standard 1-h treatment.', 'Chronic pruritus , defined as itch persisting more than 6 \xa0 weeks , is a debilitating problem that affects one in four elderly adults .', 'Assess the efficacy of a Rhealba<sup>®</sup> Oat Extract-based emollient in the management of chronic pruritus in elderly outpatients.', 'Pruritus frequently reduces quality of life (QOL) in patients with senile xerosis.', 'Pruritus prevalence and intensity are very high across all dermatoses studied; intensity is linked to impairment in many areas of daily functioning.', 'Fifty patients with chronic pruritus were included, 62% were male, and the average age was 60.', 'At treatment end, pruritus, assessed by a global score, improved significantly more in the CC than in the vehicle group (79.', 'To investigate characteristics, including localization patterns, and burden of pruritus in patients with chronic dermatoses.', 'In both treatment groups, there was a reduction in pruritus scores, disease activity and DLQI.', 'In this double-blind randomized clinical trial, 53 patients suffering from inflammatory skin diseases with pronounced itching (Visual Analogue Scale (VAS) for pruritus ≥5) were randomized into two treatment groups.', 'Objective of this study was to evaluate the efficacy and safety of CC in alleviating pruritus in patients with dry itchy skin.']


Cluster  1356
['Inhalational anthrax is a life-threatening infectious disease of considerable concern , especially as a potential bioterrorism agent .', 'In the present study , we evaluated the clinical diagnosis and treatment of cutaneous anthrax , a rare disease that nonetheless remains a serious healthcare problem in developing countries .', 'Bacillus anthracis remains a serious bioterrorism concern , and the currently licensed vaccine remains an incomplete solution for population protection from inhalation anthrax and has been associated with concerns regarding efficacy and safety .', 'Anthrax is still a serious public health problem in Turkey .', 'Before the anthrax terrorist attacks in the United States in 2001 , there was very little interest in anthrax as a serious human pathogen ; anthrax was viewed mainly as a veterinarian problem of minor importance , with most cases attributed to occupational exposure .', 'Anthrax in Russia has for a long time posed a serious problem for public health and veterinary services .']


Cluster  2013
['At present, the application of tumor reduction surgery in oligometastatic prostate cancer has aroused extensive discussion among urologists, but clinicians have not reached a consensus on this issue', 'Accurate and consistent discrimination of prostatic carcinomas from benign lesions and vice versa continues to be a vexing problem in diagnostic pathology .', 'The need for an early and accurate detection is thus a great challenge in common clinical practice , but the lack of specificity of the serum marker PSA ( Prostate Specific Antigen ) is a serious problem since its increased concentration can be related to several abnormalities .', "Lack of efficient noninvasive biomarkers for differentiating prostate cancer ( PCa ) and benign prostate hyperplasia ( BPH ) is a serious concern for men 's health worldwide .", 'Management of prostate cancer that either is detectable by prostate specific antigen ( PSA ) measurements after curative intent or has spread outside of its capsule is a serious problem .', 'To evaluate the usefulness of imaging studies in patients with prostate cancer.', 'Half of patients with prostate cancer were classified as low risk.', 'The frequencies of early detection examinations, medically indicated PSA tests, and prostate biopsies in the Münster district were determined, using aggregated data from the regional association of Statutory Health Insurance (SHI) Physicians in Westfalen-Lippe.', 'High-risk localized prostate cancer remains a vexing problem for clinicians .', 'The treatment of prostate cancer can lead to significant economic follow-up costs which vary greatly depending on the type of treatment.', 'Overdiagnosis of clinically insignificant prostate cancer is considered a major potential drawback of prostate-specific antigen ( PSA ) screening .']


Cluster  1672
['Representing diagnostic test accuracy in natural frequencies substantially helped dentists make diagnostic inferences.', 'The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT)', "This study indicates fluorescence visualization is capable of improve inexperienced professionals' efficacy for early detecting oral lesions more prone to be dysplastic and oral potentially malignant disorders.", 'A dental student and an expert professional in oral diagnosis examined 15 randomly selected patients using conventional oral examination and fluorescence visualization searching for early signs of epithelial dysplasia and oral potentially malignant disorders.']


Cluster  1022
['Although sunbed operators are mandated to offer their customers certain services at least once since the implementation of the UVR regulation, 15.', 'The frequency and duration of coercive measures (e.g. fixation, coercive medication and preventive restraints) were routinely documented and compared in the periods before and after the relocation.', 'On March 22, 2020, a statewide stay-at-home order for nonessential tasks was implemented in New York State.', 'After the relocation the utilization of coercive measures was significantly reduced by 48-84\u2009%.']


Cluster  1966
["The argumental structure of `` switching '' is : `` schools '' -LRB- agent -RRB- ; `` constantly '' -LRB- time/frequency -RRB- ; `` uniforms '' -LRB- theme -RRB- . the resulting reliance on manually annotated examples , which are expensive and time-consuming to create", "The argumental structure of `` switching '' is : `` schools '' -LRB- agent -RRB- ; `` constantly '' -LRB- time/frequency -RRB- ; `` uniforms '' -LRB- theme -RRB- . the resulting reliance on manually annotated examples , which are expensive and time-consuming to create", "The argumental structure of `` switching '' is : `` schools '' -LRB- agent -RRB- ; `` constantly '' -LRB- time/frequency -RRB- ; `` uniforms '' -LRB- theme -RRB- . the resulting reliance on manually annotated examples , which are expensive and time-consuming to create"]


Cluster  1496
['Bolting before plants reach the harvesting stage is a serious problem in B. rapa vegetable crop cultivation .', 'Finally , we present novel software for the analysis of pod shatter data that is applicable to any crop for which seed dispersal is a serious problem .', 'The recent emergence of heritable high level resistance to phosphine in stored grain pests is a serious concern among major grain growing countries around the world .', 'Mustard aphids are a serious problem for Brassica oilseed in India causing up to 90 % of the crop damage .', 'The rapid development of chemical pesticide resistance has become a severe problem in controlling pear psylla .', 'The disease has been a serious problem in these two counties since then , especially where consecutive carrot cropping was practiced .', 'Populations of weed beets have expanded into European sugar beet production areas since the 1970s , thereby forming a serious new weed problem for this crop .', 'Curly top is a serious problem in many irrigated crops in the semiarid areas in the western United States .', 'In Ecuador , D. platura is a serious problem for the crop , Lupinus mutabilis Sweet ( Chocho ) , and it also attacks broccoli ( Brassica oleracea L. ) .', 'TSWV became a serious problem in glasshouse grown crops .', 'Beet leafhopper-transmitted curly top virus is a serious problem in many different crops in the semiarid western United States , including sugar beet , tomatoes , and beans .', 'Adulteration by using SS ( beet sugar ) still has a serious detection problem , especially in countries in which beet is used in manufacturing sugar .', 'Rape phyllody is a serious problem in rapeseed production .']


Cluster  1275
['Female athlete triad(FAT ) , which includes low energy availability with or without an eating disorder , functional hypothalamic amenorrhea , and osteoporosis , is a serious healthcare concern in female athletes .', 'Although there are numerous benefits to women from athletic participation , a complex combination of endocrine and metabolic factors exaggerates risk for a serious health concern : the female athlete triad .', 'Female athlete triad ( FAT ) is a serious healthcare concern in the young female population .', 'The female athlete triad ( FAT ) is a serious health-related problem that threatens women who exercise .']


Cluster  37
['Biliary and pancreatic involvement , frequently encountered in endemic areas , is a serious public health problem .', 'None of the nutritional assessment scores defined malnutrition relevant to complications after pancreatic surgery and these scores may thus be abandoned.', 'Malnutrition is a serious concern , but short-term experience with intraperitoneal amino acids promises success in the management of this complication .', 'The study shows that it is possible to perform IC in a rural setting reducing complications of waiting and in particular, rates of GS-related pancreatitis were significantly reduced.', 'Diarrhea is a common complication of enteral nutrition (EN), which affects recovery and prolongs the length of hospital stay (LOHS).', 'Infection remains a drawback of parenteral nutrition ( PN ) , probably related , among other factors , to immunosuppressive effects of its lipid component .', 'Fungal infections constitute a serious clinical problem in the group of patients receiving total parenteral nutrition .', 'COINN is a randomized, monocentric study for critically ill adult patients receiving enteral nutrition.', 'Nutrition has been neglected for a long time as an important factor in the pathogenesis of digestive diseases, but also in the treatment, despite Hippocrates long ago insisted "Let food be thy medicine and medicine be thy food', 'The not well known parenteral nutrition-related liver disease is a serious problem associated to short bowel and long-term parenteral nutrition ( PN ) use , and BT is also frequent in those patients .', 'Forty multiple trauma patients requiring enteral nutrition for at least 10 days were randomly assigned to the intervention group (n=20) or the placebo group (n=20).', 'Parenteral nutrition-associated liver disease remains a vexing problem .', 'Enteral nutrition ( EN ) misconnections have been identified as a serious and potential deadly problem .']


Cluster  2369
['Nosocomial sepsis is a serious problem for neonates who are admitted for intensive care .', 'Neonatal late-onset sepsis ( LOS ) is a serious problem in neonatal intensive care .', 'Nosocomial sepsis is a serious problem for neonates who are admitted for intensive care .', 'Neonatal early-onset sepsis is a serious health concern for term and late preterm infants .']


Cluster  244
['The results of the study suggest the feasibility of reducing parenting stress in parents with mild intellectual disability (MID) through parenting support, to the possible benefit of their children.', 'Developmental disabilities exert severe physical, cognitive and social-emotional consequences, such as low quality of life, not only on children but also on their families', 'Learning disabilities ( LDs ) in children are a serious global problem .', 'We contrasted parents who had a child with a developmental disability , a serious mental health problem , and a normative comparison group with respect to parental attainment and well-being at mid-life .', 'Since the DSM-5, adaptive functioning has taken a prominent place in the classification of intellectual disability (ID)', 'Although the prognosis for survival in people with severe functional disabilities is a serious concern for their families and health care practitioners , there have been few reports on survival rates for this population .', 'Falls among older adults with intellectual disability ( ID ) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care .', "This paper questions consumerist assumptions in current English social care policy and aims to look behind the processes of personalization to interrogate what 'choice and control' means in the lives of a diverse group of people with intellectual disabilities", 'To test a Read Code search supporting the identification of people with a mild-to-moderate learning disability who are not currently on the learning disability register.', 'The purpose of this thematic synthesis was to review qualitative studies on perspectives of persons with intellectual disabilities regarding friendships and intimate relationships', 'Acceptance of disability is a serious problem in this group of SCI survivors in Neiva , Colombia , especially among women and individuals with higher levels of depression .', 'Cases with disability were significantly more likely to report a serious health problem in the last year compared to controls in both India ( OR \u2009 = \u2009 3.2 , 95 % CI 2.1 - 4.8 ) and Cameroon ( OR \u2009 = \u2009 1.9 , 1.4 - 2.7 ) .', 'Using data from the Wisconsin Longitudinal Study , a population-based study of midlife adults , the authors compared parents who have a child with a severe mental health problem , a child with a developmental disability , or a child with no chronic illness or disability .', 'Moreover , the criticisms of these two sets of views reveal that attempts to describe the phenomenon of disablement which focus on the individual suffer from a serious methodological shortcoming .', 'Intellectual disability ( ID ) is the most frequent cause of serious handicap in children and young adults and interests 2 - 3 % of worldwide population , representing a serious problem from the medical , social , and economic points of view .', 'Interpersonal violence ( IPV ) is a serious and often unrecognized problem for men with disabilities ( MWD ) .', 'Reading disability ( RD ) is a serious epidemiologic problem and may affect up to 15 % to 20 % of elementary school children .']


Cluster  29
['This report points out a serious regulatory problem regarding the management of second-hand clothes prior to sale and , more generally , of controls in street markets .', 'Leather wastes tanned with chromium are generated during the production process of leather , hence the wastes from hand crafted goods and footwear industries are a serious environmental problem .', 'The disposal of by-products of duck production , including duck skin , is a serious concern as it results in environmental pollution .', 'The disposal of by-products of duck production , including duck skin , is a serious concern as it results in environmental pollution .', 'Massive consumption of cotton fabrics has brought up a serious problem concerning the waste cotton fabrics ( WCFs ) disposal .', 'Various scientific studies confirm that the disposal nature of fast fashion and throwaway culture is resulting in a serious environmental , health , social and economic concern .']


Cluster  594
['This pilot study shows the possibility that HCV eradication by SOF/LED was accompanied by an improvement of glucose metabolism in the population with or without diabetes, and suggests further investigation.', 'We conclude that chronic hepatitis affect the serum profile of transferrin isoforms, but only trisialotransferrin level could be useful in determining progression of chronic hepatitis and the stage of fibrosis.', 'Tenofovir disoproxil fumarate (TDF) is recommended as first-line monotherapy for nucleos(t)ide (NA)-naïve chronic hepatitis B (CHB) patients and as a second-line rescue therapy for NA-experienced patients with a previous treatment failure.', 'Anemia is common in patients with severe chronic liver disease, but its role in HBV-related decompensated cirrhosis (DeCi) is still unclear', 'Treatment with SOF + DCV without RBV for 24 weeks is safe and effective in cirrhotic patients who failed triple therapy with the first generation of protease inhibitors.', 'In patients with chronic hepatitis tetrasialotransferrin level was increased (P=0.', 'Recently , HBV-related acute on chronic liver failure ( HBV-ACLF ) has emerged as a serious and emergent medical problem in Bangladesh .', 'HEP-25/ERFE ratio could be a novel prognostic marker for increases in Hb levels following FCH administration.']


Cluster  407
['A fundamental problem with applying Consensus , Weight-Matrix or hidden Markov models as search tools for biosequences is that there is no way to know , from the model , if the modeled sequences display any dependencies between positional identities .', 'The problem with this solution is that the search space of the problem grows exponentially with respect to the number of β-strands .', 'This result emphasizes a serious problem that may be encountered in comparative studies of DNA structure and composition if selective loss of specific DNA sequences occurs .', 'The main problem with this approach is that the variance of the control set is dependent on the number of sequenced fragments .', 'This clearly suggests ( a ) that the amino acid frequencies of conservative proteins are free from the drastic bias of genome G+C content , which is a serious problem in the widely used tree of ribosomal RNA , and ( b ) that protein phylogeny gives a robust estimation for the early divergences in the evolution of eukaryotes .', 'The origin of spliceosomal introns is a vexing problem .', 'Despite claims to the contrary , we show that the counterexamples successfully detected a drawback of the original UCA test , of relying on sequence similarity .', 'A serious drawback of peptide nucleic acids ( PNAs ) from an application perspective that has not been adequately dealt with is nondiscrimination of identical DNA and RNA sequences .']


Cluster  2374
['Attrition is a serious problem in many clinical trials .', 'Incomplete data due to premature withdrawal ( dropout ) constitute a serious problem in prospective economic evaluations that has received only little attention to date .', 'We conclude that attrition may affect the descriptive outcomes of aging studies , particularly when such studies focus on health and function , but that attrition not always seems to be a serious problem when associations between variables are the focus of study .', 'Attrition of study subjects remains a serious problem in RCTs .']


Cluster  1316
['We observed tumor motion during BH with a mean absolute maximum displacement over all BHs of 4.', 'Even though the Wang system of classification is used by majority of reports due its clinical utility , it has a drawback of not taking into account the tumour size as done by the AJCC system .', 'The presence of excessive heterogeneity among and within sublines poses a serious problem for experimental oncologists using these sublines in their tumor models .', 'We observed substantial pancreatic tumor motion during BH as well as considerable position variation between consecutive BHs on a single day.', 'High interobserver variation is a well known drawback of conventional tumor regression grading , and reaching consensus among pathologists may require a considerable effort .', 'But a major drawback of the tumour models is the difficulty of visualizing endogenously formed tumours .']


Cluster  2064
['Medusahead is a serious management concern because it decreases biodiversity , reduces livestock forage production , and degrades the ecological function of rangelands .', 'Our projections indicate that up to 86 % of thermo-suitable habitat could be lost by 2085 , a serious conservation concern for the species .', 'Within Australia , koala over-abundance has become a serious problem in some areas resulting in significant damage to native forests through defoliation .', '1 . Selective harvesting is acknowledged as a serious concern in efforts to conserve wild animal populations .', 'It is a vexing problem to achieve a consensus about the proper scientific way to assess population viability for habitat conservation plans .', 'The overabundance of large herbivores is now recognized as a serious ecological problem .', 'The decline of habitat for elephants due to expanding human activity is a serious conservation problem .']


Cluster  1304
['The influenza virus is one of the major pathogens that seriously affect human health', 'Epidemics of influenza occurring each year in Poland in winter are a serious health problem and bring underestimated financial losses .', 'Influenza is one of the most common human respiratory diseases , and represents a serious public health concern .', 'Of several infections , influenza virus infection is considered a serious problem .', 'Flu caused by influenza viruses , is a serious public health problem all over the world with its high morbidity and mortality .', 'Influenza is a serious public health concern worldwide , as it causes significant morbidity and mortality .', 'Influenza A virus induces severe respiratory tract infection and results in a serious global health problem .', 'Influenza infection and associated epidemics represent a serious public health problem .', 'Influenza is a serious public health problem and the ED is an important healthcare location to educate patients .', 'Influenza virus is a serious health concern .', 'Currently , H5N1 influenza viruses remain a serious public health concern in Asia and now in Europe .', 'Influenza is a serious economic concern due to the costly countermeasures it necessitates .', 'Influenza is a serious public health problem that causes severe illnesses and deaths for higher risk populations .', 'Influenza is an acute respiratory illness and has become a serious public health problem worldwide .', 'Influenza A virus ( IAV ) poses a severe threat to human health and is a major public health problem worldwide .', 'Influenza virus infections are a serious public health concern throughout the world .', 'Influenza remains a serious health problem , annually causing epidemics embracing up to 10 % of the population of the world , and at the periods of pandemics this number may rise 4- to 6-fold .', 'Influenza is a serious public health concern , resulting in morbidity , mortality and significant expense to healthcare systems worldwide .', 'Influenza is a serious public health problem , since seasonal epidemics affect approximately 5 - 10 % of the population and thus give rise to a heavy social and healthcare burden .', 'Influenza A viruses cause major morbidity and represent a severe global health problem .', 'Influenza is a serious health problem in Europe .', 'Seasonal and pandemic influenza infections remain a serious public health concern .', 'Influenza viruses remain a serious public health problem .', 'As healthcare-associated influenza is a serious public health concern , this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel , implementation issues and evidence of effectiveness .', 'Influenza type A is considered as a severe public health concern .', 'Influenza is a serious health problem worldwide .', 'Influenza is a highly contagious respiratory tract disease and is considered a serious community health problem .', 'The RNA virus influenza A is a serious public health problem , with epidemics resulting in more than 250 \u2009 000 deaths every year .', 'Influenza remains a serious worldwide public health problem .', 'Influenza represents a serious public health concern .']


Cluster  12
['Five-year follow-up of a randomized, multicenter trial on LAR (NCT 00636948) with (stoma; n\xa0=\xa0116) or without (no stoma; n\xa0=\xa0118) defunctioning stoma comparing inpatient healthcare resources and costs.', 'Although mortality was similar in both arms, the rate of stoma reversal was significantly higher in the PA arm.', 'PTS reduced the rate of seroma formation to 3.', 'A serious medicolegal problem after surgery : gossypiboma .', 'There was a significant reduction in the incidence of seroma formation favoring the fibrin glue group when compared to the control group (P\xa0=\xa00.', 'Gossypiboma is a serious and potentially dangerous medico-legal problem .']


Cluster  943
['This work is a part of a comprehensive research project to assess and provide educational intervention that potentially improve psychological status and blood glucose among patients with T2DM.', 'Implementation intentions are a promising approach to support the self-management of depression.', 'While current findings have promise in demonstrating the conditional effects of planning interventions, there is a need to replicate these findings by manipulating planning and beliefs independently and testing their direct and interactive effects on medication adherence.', 'After 3 months, compared to patients who received education alone, those in the group-based acceptance and commitment therapy condition were more likely to use effective coping strategies, reported better diabetes self-care, and optimum glycated hemoglobin (HbA1C) levels in the target range.', 'The empowerment program was shown to have short-term, positive effects on behavioral, physical, and psychosocial outcomes in a Taiwan population with prediabetes.', 'To describe an experimental study protocol that aims at implementing and evaluating the effect of the "action planning and coping planning" interventions on medication adherence to OADs in patients with type 2 diabetes mellitus (T2DM) in follow-up at primary care services.', 'The aims of this study were to develop an empowerment program for people with prediabetes and to examine its efficacy in terms of the adoption of a health-promoting lifestyle and improvements in blood sugar, body mass index, and self-efficacy.', "An intention-to-treat analysis of between-groups at 12-month (mean difference, 95% CI) revealed that the Co-HELP participants' mean fasting plasma glucose reduced by -0.", 'Diabetes mellitus is being increasingly recognized as a serious global health problem and is frequently associated with co-morbid depression .']


Cluster  1728
['The number of patients with shivering was higher in Group C (13) than in Group D (2) and Group M (3) with no differences between Group D and M; P = 0.', 'A randomized controlled clinical trial was carried out among subjects admitted during the winter season at Hospital Josefina Martinez between May and October of 2013.', 'Sensitivity to cold ( hiesho ) is a serious health problem in Japan , yet it is minimally understood within Western cultures .', 'Cold intolerance is a serious long-term problem after injury to the ulnar and median nerves , and its pathophysiology is unclear .', 'To determine clinical responses and biological pathways in NAVMR subjects challenged to cold dry air (CDA) in an environmental exposure chamber (EEC) pre- and posttreatment with azelastine/fluticasone (AzeFlu), 30 NAVMR subjects, prescreened for CDA-induced symptoms (approx.']


Cluster  2336
['A potential problem with FIB-SEM CL tomography is that ion milling may change the defect state of the material and the CL emission .', 'The procedure time, X-ray exposure time, and LOS were found to be lower in the R-PSE group than in the F-PSE.', 'WLS demonstrated high feasibility of scanning PE.', 'Positron emission tomography images were obtained without complication.']


Cluster  860
['In a prospective pilot observational study from November 2012 to December 2013 auscultations by pediatricians and computer aided auscultation were performed within 12 hours of neonatal echocardiography.', 'Fetal echocardiography and velocity vector imaging were performed prospectively and serially in 48 fetuses with a small aortic isthmus and 48 gestation age-matched normal fetuses.', 'Compared with normal fetuses, fetuses with a small aortic isthmus exhibited a lower S and SR at baseline.', 'Forty parturients underwent focused cardiac ultrasound.', 'Focused cardiac ultrasound is feasible in the obstetric population and images of sufficient quality for clinical decision-making were obtained in all parturients by an operator with limited experience.', 'Phonocardiogram analysis using the novel algorithm prototype had a higher sensitivity than auscultation by pediatrician in detecting positive echocardiography findings in neonates.']


Cluster  1524
['There were 14,996 EDOU stays during the 20-month period included in the analysis.', 'Fourteen patients completed the study.', 'Twenty-eight participants were enrolled, with 14 in each group.', 'Only 14 (13.', 'Fourteen subjects participated in the eight-week study.', 'The analysed data showed that 13.']


Cluster  438
['The test group had significantly increased skin hydration and gloss and decreased wrinkling compared to the placebo group at 12\xa0weeks.', 'To compare the efficacy of moisturizer containing 4-t-butylcyclohexanol, which acts as a sensitivity regulator, and licochalcone A, an anti-inflammatory agent from the licorice plant Glycyrrhiza inflata, with that of 0.', 'The test facial moisturizer was slower than 0.', 'Both concentrations offered reduction of facial laxity and wrinkles, with no statistical difference.', 'Patients treated with 10% and 20% D/DC showed significant improvements in skin dryness and scratch mark scores, as well as increased skin conductance, compared with the untreated group, whereas white petrolatum treatment improved only skin dryness scores.', 'Horse oil (HO) has skin barrier restoration and skin-moisturizing effects.', 'Our results indicate that the change of hydration of the SC is equivalent to the skin damage caused by surfactants, and therefore is the most suitable indicator to evaluate the irritation of surfactants on the skin.', 'During the test period, the atmospheric temperature increased and skin dryness and scaling significantly improved with or without application of the moisturizing gel.', 'Significant changes were observed only in hydration, TEWL, and natural moisturizing factors (NMF) content in the SC following surfactant exposure.', 'The aim of this study was to investigate the clinical efficacy of B.\xa0pandurata intake on skin hydration, gloss, wrinkling, and elasticity.', 'Topical application of an emollient containing D/DC is effective in improving skin dryness and pruritus in patients with senile xerosis.', 'Twice-daily application of 5% topical vitamin C led to a clinically apparent improvement of the skin symptoms and allows beneficial effects on skin elasticity and thickness.']


Cluster  1404
['Lung cancer is the leading cause of cancer mortality worldwide', 'Lung cancer remains a serious oncological problem worldwide .', 'Lung cancer ( LC ) is a serious public health problem responsible for the majority of cancer deaths and comorbidities in developed countries .', 'Lung cancer still poses a serious epidemiological problem in Poland and the number of years of life lost due to this cause reflects social and economic implications of premature lung cancer-related mortality .', 'Lung cancer ( LC ) is a serious health problem due to its high incidence and mortality .', 'This data shows an increasing frequency of lung cancer in Mexico city as well as other countries , it also shows that it is going to be a serious health problem in the future .', 'Lung cancer is a serious health problem in public .', 'Lung cancer is not only a serious disease but also a public problem threatening human health all over the world .']


Cluster  77
['The thyroid volume measured in a sitting position was significantly lower than that measured in the supine position.', 'A significant drawback of the radioisotopic scanning of the thyroid gland is the absence of a distinct knowledge of topographo-anatomical associations of this gland with other organs and tissues .', 'Detection of ectopic thyroid remnants : a serious diagnostic dilemma . When molecular biology and immunohistochemistry can solve the problem .', "Graves' hyperthyroidism causes increased cardiac output and a hyperdynamic right ventricle which normalise on restoration of the euthyroid state.", 'Thyroid-associated ophthalmopathy remains a vexing medical problem , the pathogenesis of which remains uncertain .', 'The data from a sample of 2042 children and adolescents aged 10-18years who underwent a nationwide Korean representative sampling and cross-sectional survey with blood collection for a thyroid function test using an electrochemiluminescence immunoassay were evaluated.', "Eight individuals with Graves' hyperthyroidism, aged 22-64 years, underwent comprehensive transthoracic echocardiography at three time points: before treatment, two weeks after commencement of carbimazole, and at six months or more when euthyroid.", 'This is a serious problem since , according to literature , 7 - 20 % of cold thyroid nodules are malignant .', "Histologic findings occasionally can not distinguish lymphoma from Hashimoto 's thyroiditis , which creates a serious problem of whether treatment should be initiated .", "The most important of the extra-thyroidal manifestations of Graves ' disease , Graves ' orbitopathy ( GO ) , remains a vexing clinical problem .", 'The prevalence of autoimmune thyroiditis (AIT) and papillary thyroid carcinoma (PTC) is rising in children and adolescents, and the coincidence of AIT and PTC is as high as 6', 'Malignant tumors of the thyroid gland are the most frequent malignant endocrine neoplasms, comprising approximately 1% of all malignant tumors']


Cluster  1219
['The intra-rater reliability was considered substantial to excellent, with ICC values ranging between 0.', 'The aim of this study is to evaluate inter-rater reliability among nurses using PEWS systems.', 'Inter-rater reliability was high ICC\u200a=\u200a0.', 'The inter-rater reliability for all items and the total score yielded good to excellent results (intraclass correlation coefficient [ICC] = 0.', 'The study showed good to very good inter-rater reliability in the two PEWS models used in the Central Denmark Region.', 'Intra- and interrater reliability of the parameters were generally excellent for both T1- (intrarater: 0.']


Cluster  1629
['Not only the potential abuse of this new amphetamine designer drug is a serious matter of concern , but also the misleading information provided with the tablet .', 'Pathological amphetamine ( AMPH ) use is a serious public health concern with no pharmacological treatment options .', 'Amphetamine ( AMPH ) use disorder is a serious health concern , but , surprisingly , little is known about the vulnerability to the moderate and compulsive use of this psychostimulant and its underlying mechanisms .', 'Amphetamine ( AMPH ) abuse is a world concern and a serious public health problem .', 'Overdose of amphetamine , related derivatives , and analogues ( ARDA ) continues to be a serious worldwide health problem .']


Cluster  652
['A less appreciated problem with caffeine is that it may increase the risk of osteoporosis and hip fracture .', 'Caffeine supplementation increased eccentric strength and power in female team-sport players taking OCS both during an intermittent running protocol and the following morning.', 'The problem with relying solely on this approach is that it leaves open the question as to whether the results obtained are due to beneficial effects of caffeine or to deleterious effects of caffeine deprivation .', 'Caffeine ingestion improved jump height (+3.', 'Caffeine supplementation significantly increased eccentric strength of the knee flexors (<i>P</i>\u2009<\u20090.', 'These data indicated that caffeine intake and excessive water drinking could affect urinary excretion of some proteins and may affect urinary proteome analysis.']


Cluster  1486
['The rising prevalence of maternal overweight/obesity and excessive gestational weight gain poses a serious public health concern due to the contribution of these factors to increased risk of negative health outcomes for both mother and child .', 'Pre-pregnancy obesity is a serious epidemics concern that negatively affects the neurodevelopmental of the offspring .', 'Excess weight and obesity have become a serious problem in adult men of reproductive age throughout the world .', 'PPWR is a serious health and nutritional problem in Chinese women , where excess in gestational weight gain is associated with PPWR .', 'Obesity is a serious health problem with significant effects on the incidence and treatment of the gynecologic malignancies .', 'The global prevalence of obesity poses such a serious concern that the World Health Organization ( WHO ) has described it as a " global epidemic . " Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns , dietary habits , and parental feeding practices are established .', 'Obesity is a serious health problem among women across the life span .', 'Based on the analyses presented and on a review of the literature , it is concluded that obesity among women is a serious problem in Latin America and the Caribbean , the Middle East and North Africa , and the CEE/CIS region .', 'Obesity is a serious problem worldwide and particularly in the United States , and in women is associated with an increased risk of death and morbid conditions ( including hypertension , diabetes mellitus , obstructive sleep apnea , and hypercholesterolemia ) as well as malignancies such as endometrial and postmenopausal breast cancer .', 'Maternal obesity ( MO ) remains a serious obstetric problem with acute and chronic morbidities for both mothers and offspring .', 'Insufficient physical activities are a serious problem in the pregnant women of Chengdu over the last two trimesters .']


Cluster  324
['The coprimary effectiveness end points were met.', 'The primary end point was met.', 'The quality of the sessions provided was rated as good.', 'Parallel-test reliability values of the three standard patch test preparations turned out to be acceptable, with slight advantages for the strip patch test.', 'Implementation of a threshold compliance tool was associated with a marked and significant reduction in out-of-range ICP values.', 'Our group developed a threshold compliance tool.', 'The global aesthetic score was used to evaluate improvement.', 'A total of 1306 quality control tests were conducted; 84% passed pre-issue and 87% return testing.']


Cluster  807
['Fragility fractures pose a serious health care problem in Russia .', 'Fractures of the proximal segment of the femur occurring most commonly in elderly patients are a serious , both medical ( orthopaedic ) and socioeconomic , problem .', 'Proximal femoral ( hip ) fractures are the leading cause of hospitalization for injuries among older persons and constitute a serious health problem .', 'The treatment of fractures of the tibial plateau or distal femur often represents a severe problem in geriatric patients .', 'Cast immobilization is effective in the majority of patients after CR of displaced forearm fractures.', 'A total of 162 elderly patients with OP fracture treated in three third-grade general hospitals of Jiangsu Province from January 2016 to September 2016 participated in this study.', 'There were 9 fractures in the Extensile group and 12 in the MIS group, with both groups having comparable demography, fracture classification, surgery delay & initial radiology.', 'Fragility fracture is a serious public health problem in the world .', 'This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, tibia, fibula, or femur.', 'Eighty-nine cases of tibia diaphyseal fracture who needed to treat by intramedullary nails were analyzed retrospectively, and were divided into 2 groups.', 'The treatment of large and recalcitrant bone wounds is a serious clinical problem , and in the United States approximately 10 % of all fractures are complicated by delayed union or non-union .', 'Open fractures , especially III grade open fractures of the tibial diaphysis , according to the Gustilo classification still remains a serious therapeutic problem .', 'Eighty-two patients with unstable intertrochanteric fractures between 2011 and 2013 were included in this study.', 'Non-union of fractured neck of femur in young adults is a serious problem .', 'Fractures in the craniofacial region are a serious problem in terms of treatment .', 'It is suggested that LIPUS stimulation can lead to a reduction of treatment periods of unstable forearm fractures safely after operation even in children.', 'Treatment of the above fractures is not always simple and represents a serious problem in everyday traumatological practice .', 'Unstable intertrochanteric fractures of the hip , especially reverse oblique fractures are a serious problem in traumatology , as there is no standard method of treatment and inadequate treatment carries a significant complication rate .']


Cluster  1984
['Biliary complications remain to pose a serious problem in patients after liver transplantation .', 'Bile leakage after living donor liver transplantation ( LDLT ) remains a serious problem , resulting in lower survival rates .', 'Biliary complications are a major drawback of liver transplantation .', 'Preservation injury to bile ducts is a serious problem in liver transplantation , especially when preservation exceeds 12 hours .', 'Biliary complications are a serious problem in patients after liver transplantation and often require reoperation .', 'Biliary anastomotic stricture occurs in 15% to 20% of patients after deceased orthotopic liver transplantation (OLT).']


Cluster  1916
['In recent years , BK virus ( BKV ) nephritis after renal transplantation has become a severe problem .', 'We performed a prospective, single-center, randomized, open label pilot trial to evaluate the impact of mycophenolate mofetil (MMF) withdrawal with conversion to the mTORi everolimus versus a 50% reduction of the MMF dose for the treatment of BKV infection after kidney transplantation.', 'Our novel protocol prevented late-onset CMV infection and disease beyond 1 year post-transplantation in D+/R- recipients.', 'Viral infections are still a serious diagnostic and therapeutic problem in patients undergoing alternative donor transplants .', 'Polyomavirus BK-associated nephropathy ( BKVN ) has been a serious problem after kidney transplantation .', 'Chronic HBV infection in kidney , heart , and other organs has become a serious long-term problem and one of the most frequent and important comorbidities affecting graft and patient survival .', 'Cynomolgus kidney was the best single tissue culture for reisolation of the six viruses , but foamy-virus contamination of many lots was a serious problem .', 'Primary or recurrent viral infections , especially by herpetoviridae , with viraemias -- after organ transplants , for example -- are a serious medical problem which can affect the prognosis for survival .']


Cluster  628
['Possibly, the IVS4+44-AA-related dysregulation of the iron-induced changes in DMT1 expression is not able to impair iron absorption in physiological condition.', 'Complete MPC1 deficiency is a serious concern , and has been shown to result in embryonic lethality in mice .', 'The levels of FTMT mRNA in the reticulocytes of patients (30 regularly transfused and 30 rarely transfused) and 30 healthy individuals were assessed by quantitative reverse transcription-polymerase chain reaction.', 'The levels of FTMT mRNA, ferritin and MDA in both groups of patients were significantly increased compared with those in the healthy controls.', 'Ficolin-1, ficolin-2, MBL, C4 and C3 in ascitic fluid and ficolin-1, C4 and C3 in blood were significantly (p\u2009=\u2009.', 'This genetically-altered mouse line provides an excellent animal model to study consequences of a severe FVII deficiency in unchallenged mice and in mice subjected to a variety of experimental challenges .', 'We observed higher fibronectin-levels at 12-16 weeks (p < 0.', 'Mice with an excess or a severe reduction of 5-HT during development , such as the MAOA and the VMAT2 KO mice , show abnormalities that concern late stages of development : alterations in axon branching , dendritic remodeling and developmental cell death .']


Cluster  1036
['Of 499 physician-diagnosed cases reported by 132 clinical centers, 358 cases met the criteria for possible ABPA-CB.', 'The study included 126 patients with PAD stage II, according to the Fontaine Classification, who over a period of 2 years attended an angiological outpatient clinic and were referred for physical rehabilitation.', 'This nationwide survey identified several unique clinical characteristics of ABPA in Japan, such as late-onset, relatively lower serum IgE levels, and frequent recurrences/flares.', 'The majority of the patients included in the case series had clinical stage iii and iv disease.', 'Fifty-two patients with previous diagnosis of stage I-IIa CC suffering from VVA and treated with ospemifene were enrolled into a single arm prospective study.', 'We performed a retrospective, observational cohort study of all (n=16,121) adult patients (88% from MN, IA and WI) presenting during 2014 with AAP.', 'We reviewed 107 patients with systemic AL to identify the impact of a diagnostic FISH study done on plasma cell-enriched bone marrow in our institution between January 2010 and January 2015; 77 had pre-treatment testing performed.', 'In a cross-sectional discovery cohort, we enrolled 33 patients with AA and 35 HCs from the same geographic location in Shanghai, China.']


Cluster  621
['Locoregional failure of rectal cancer is a troublesome problem and a major cause of morbidity and mortality following curative surgery .', 'In patients with low rectal cancers undergoing ULAR plus coloanal anastomosis, bowel dysfunctions were severe.', 'Eighty patients with rectal cancer who received chemoradiotherapy were randomly assigned to receive no tattooing (C group) or to receive tattooing (T group).', 'miniprobes and especially three-dimensional endoscopic ultrasonography may be relevant during rectal cancer staging.', 'However , distant metastasis is still a serious problem after seemingly curative resection in patients with rectal cancer .', 'In the current strategy against locally advanced and recurrent rectal cancers possibly involving intrapelvic nerves , there has been a serious dilemma between extensive surgery and limited surgery .', 'Anastomotic leakage is a serious problem in the laparoscopic resection of rectal cancer .', 'The more frequent overstaging of small tumors within one quadrant of the rectum is a major drawback of digital examination .', 'One hundred and thirty-one patients with rectal cancer were randomly assigned to the control group in which lymph nodes were harvested by palpation and sight, or to the methylene blue group using a modified method of injection into the superior rectal artery with methylene blue.', 'Of 785 patients with rectal cancer between 2005 and 2015, 362 had non-metastatic locally advanced tumours treated with neoadjuvant CRT.', 'On the basis of acceptable oncologic results, ultralow anterior resection (ULAR) and colo-anal anastomosis plus hand-sewn coloanal anastomosis have been performed for treating very low-lying rectal cancer.', 'The modified method with methylene blue injection improved lymph node harvest in rectal cancer, especially small node and metastatic node retrieval, which provided more accurate staging.', 'Afilbercept plus 5-FU-based chemoradiation was tolerated in patients with localized rectal cancer and showed a pCR rate within range of historical data.']


Cluster  1118
['Seventy-four patients with a chronic or recurrent lifetime history were randomly allocated to receive either a brief mindfulness-based intervention (MBI) encompassing three individual sessions and regular home practice or a control condition that combined psycho-educational components and regular rest periods using the same format as the MBI.', 'A pilot study investigating an 8-week web-based mindfulness intervention with a pre-post design and follow-up after 3 months, with mindfulness as the primary outcome and perceived stress, caregiver burden and self-compassion as secondary outcomes.', 'To evaluate and quantify the intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver-delivered reflexology for people with breast cancer.', 'In a three-arm randomised controlled mixed-method trial, participants were assigned to: 1) Mindfulness for Multiple Sclerosis (M4MS) (n=18); 2) Chair Yoga (n=18); or 3) wait-list control group (n=19) for eight weeks.', 'Online mindfulness programs are feasible and acceptable for people with MS.', 'Training in mindfulness has been introduced to the treatment of depression as a means of relapse prevention.']


Cluster  245
['Among these , 1000 posts were randomly selected then manually split into sentences . ignoring many links that might reflect true – although less frequently attested – conceptual relations', 'The Fmeasure suggests that category terms better capture the semantics of an article when compared to the text of the article . This bias towards outliers', 'The Fmeasure suggests that category terms better capture the semantics of an article when compared to the text of the article . This bias towards outliers', 'However , in the citations dataset , where a citing sentence may cover no information about the cited paper , randomization has the drawback of selecting citations that have no valuable information in them', 'While such an analysis surely yields the most reliable links , it has the drawback of ignoring many links that might reflect true – although less frequently attested – conceptual relations', 'Semantic analysis is an open research field in natural language processing . selecting citations that have no valuable information in them']


Cluster  2017
['Electrochemotherapy with bleomycin was combined with open liver resection and performed with linear or hexagonal needle electrodes according to an individualized pretreatment plan.', 'Electrochemotherapy is a novel ablation technique combining chemotherapeutic agents with reversible cell membrane electroporation.', 'Results of the ICD-ON protocol demonstrate safe and efficient management of patients with CIEDs based on electrosurgery location, with 69% requiring no reprogramming or magnet application.', 'Replacing conventional electrocautery by PlasmaBlade™ for CIED procedures is feasible with a moderate rate of perioperative complications compared to the literature.', 'Irreversible electroporation is a novel method of ablating living tissues through its non-thermal effects , unlike radiofrequency ablation which has a severe problem of heat sink .', 'A total of 9 colorectal liver metastases were treated in 5 patients with 20 electrode applications.']


Cluster  1414
['A subject-masked, randomised, cross-over design was employed.', 'An exploratory randomized crossover study was performed on 20 adult volunteers who served as their own controls during the analysis.', 'Experimental study, randomised cross-over design.', 'Prospective study, crossover design.', 'A randomized crossover study design was used.', 'Randomized cross-over study.', 'The study was a randomised, controlled, crossover study.', 'A prospective randomized crossover study was conducted.', 'A randomized crossover simulation study was conducted.', '- We performed a randomized, crossover clinical trial.']


Cluster  334
['In patients undergoing laparoscopic surgeries , postoperative nausea and vomiting ( PONV ) is a serious concern .', 'The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV).', 'The aim of this study is to assess the effect of sugammadex on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.', 'Sugammadex administration in children resulted in faster recovery and extubation times and lower incidence of adverse events compared with neostigmine.', 'In the first postoperative hour 13 patients in Group N (27%) and 4 in Group S (8%) were observed to have nausea and/or vomiting and the difference was statistically significant (p=0.', 'Postoperative nausea and vomiting ( PONV ) remains a troublesome problem .', 'Post-operative vomiting , especially in ambulatory surgical patients , remains a troublesome problem .', 'Postoperative nausea and vomiting ( PONV ) is a serious concern in patients undergoing laparoscopic cholecystectomy ( LC ) , with an incidence of 46 to 72 % .']


Cluster  2384
['The indication profile for TaTME was comparable between the v-TaTME and the e-TaTME group.', 'Significant differences in TMT-A and B (P\u200a=\u200a.', 'CUSUM test showed that positioning of the PST significantly differed from the target throughout the study.', 'Between group analyses of dependent variables revealed significant differences within PST measurements (p\xa0=\xa00.', 'Intervention and control groups were not directly comparable so outcome was analysed using t-tests.', 'Paired t-test analysis showed significant increases in the TAC status, as compared to the baseline in all groups (P\xa0≤\xa00.']


Cluster  1324
['Four patients who underwent less correction of LR recession in the affected eye to correct intermittent exotropia and AHP to the contralateral side in type 1 DRS were enrolled.', 'Despite the high prevalence of recurrent aphthous stomatitis (RAS), its etiology is not yet completely clear and there is no completely remedial treatment available at present.', 'Seventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus.', 'Less correction of ipsilateral LR recession may be useful for correcting intermittent exotropia and AHP in patients with type 1 DRS.']


Cluster  1729
['Antimicrobial resistance is a serious problem because of the scarcity of new antibiotics effective against pathogens such as methicillin-resistant Staphylococcus aureus , β-lactamase-producing Gram-negative bacteria and multidrug-resistant Mycobacterium tuberculosis .', 'Bacteria with intrinsic resistance to antibiotics are a worrisome health problem .', 'In recent years , the increasing number of antibiotic-resistant bacteria has become a serious health concern .', 'Antibiotic resistance is an increasing phenomenon and has become a serious public health concern .', 'Antibiotic overuse and the emergence of " superbugs " that are resistant to their effects is a global problem that is becoming a serious concern .', 'Antibiotic ( antibacterial ) resistance is a serious global problem and the need for new treatments is urgent .', 'Intrinsic resistance to antibiotics is a serious therapeutic problem in the case of many bacterial species .', 'A major drawback of most studies on how bacteria become resistant to antibiotics is that they concentrate mainly on bacteria that can be cultivated in the laboratory .', 'Currently, antibiotic-resistant pathogenic bacteria are emerging as an important health problem worldwide', 'The emergence of bacterial resistance to the major classes of antibiotics has become a serious problem over recent years .', 'Resistance to antibiotics is a serious worldwide problem which is increasing and has implications for morbidity , mortality , and health care both in hospitals and in the community .', 'The emergence and spread of antibiotic resistant bacteria has become a serious problem worldwide .', 'Bacterial resistance to antibiotics has become a serious problem of public health that concerns almost all currently used antibacterial agents and that manifests in all fields of their application .', 'The worldwide escalation of bacterial resistance to conventional medical antibiotics is a serious concern for modern medicine .', 'Currently , the increasing resistance of microorganisms to antibiotics is a serious problem .', 'Drug resistance is a common phenomenon of pathogens , creating a serious problem of inactivation of drugs and antibiotics resulting in occurrence of diseases .', 'Widespread antibiotic resistance , especially of Gram-negative bacteria , has become a severe concern for human health .', 'Antibiotics are a mainstay of treatment for acne , yet the emergence of resistance against the currently approved antibiotics is a serious concern .', 'Antibiotic resistance has become a serious global problem that threatens public health .', 'Antibiotic tolerance is a serious clinical concern , since tolerant bacteria have considerably increased abilities to resist killing by bactericidal drugs .', 'Currently , the increasing antibiotic resistance is a serious and global problem .', 'Disease caused by antibiotic resistant pathogens is becoming a serious problem , both in human and veterinary medicine .', 'Nowadays , antibiotic resistance is a serious global health concern , for it is observed every- where on the earth .', 'Recently , the rapid emergence of antibiotic-resistant pathogens has caused a serious health problem .', 'The ever-increasing resistance to antibiotics is a serious worldwide problem .', 'The evolution of drug resistant bacteria is a severe public health problem , both in hospitals and in the community .', 'Antibiotic resistance has emerged as a serious global public health problem and lately very few antibiotics have been discovered and introduced into clinical practice .', 'However , bacteria have also acquired antimicrobial-resistance genes or changed their own genes to oppose these antimicrobial agents , and now drug-resistant bacteria are becoming a serious clinical concern .', 'Increasing resistance of pathogenic bacteria to antibiotics is a serious problem in health care system and has intensified the search for potent novel drugs .', 'The rapid emergence of bacterial resistance worldwide is a serious problem , leading to many therapeutic failures and rendering inactive effective antibiotics currently used .', 'Antimicrobial resistance towards conventional antibiotics is a serious problem for modern medicine and for our society .', 'As the development of new antimicrobial agents faces a historical decline , the issue of bacterial drug resistance has become a serious dilemma that threatens the human population worldwide .', 'Although most physicians view antibiotic resistance as a serious national problem , perceptions about its local importance , its causes , and possible solutions vary more widely .', 'The effect of mutations conferring antibiotic resistance can depend on the genetic background', 'The association between antibiotic resistance and virulence determinants should be monitored , as it constitutes a serious public health problem .', 'The development of new mechanisms of resistance among pathogens , the occurrence and transmission of genes responsible for antibiotic insensitivity , as well as cancer diseases have been a serious clinical problem around the world for over 50 years .', 'The resistance in microorganisms against many conventional antibiotics has become a serious global health problem .', 'Antibiotic resistance is a dire clinical problem with important ecological dimensions .', 'The growing resistance of many strains of bacteria to antibiotics and antiseptics is becoming a serious problem in medicine .', 'Antibiotics resistance is becoming a serious problem associated with fatalities and suffering patients .', 'Bacterial resistance to antibiotics is becoming a serious problem worldwide .', 'Antibiotic resistance is a serious problem in health care and is of widespread public concern .', 'resistance of bacteria is a serious problem of modern medicine .', 'The spread of drug resistance amongst clinically-important bacteria is a serious , and growing , problem [ 1 ] .', 'Antibiotic resistance is a serious problem that continues to challenge the healthcare sectors and has become increasingly alarming in the past few years .', 'The growing resistance of microorganisms towards antibiotics has become a serious global problem .', 'Antibiotic-resistant bacteria have become a serious problem worldwide , caused in part by the excessive use and discharge of antibiotics into the environment .', 'Antibiotic-resistant opportunistic pathogens have become a serious concern in recent decades , as they are increasingly responsible for hospital-acquired infections .', "Nowadays , drug-resistant microbes are becoming a serious clinical problem threatening people 's health and life .", 'The development of drug-resistant bacteria from the overuse of antibiotics is a serious problem , with overutilization threatening to disarm caregivers and their patients even as together they face increasingly virulent strains of microbes .', 'Antibiotic-resistant bacterial infections are a vexing global health problem and have rendered ineffective many previously-used antibiotics .', 'Antibiotic resistance has evolved over the past 50 years from a merely microbiological curiosity to a serious medical problem in hospitals all over the world .', 'Antimicrobial resistance is a serious problem that compromises the empirical treatment of infections , resulting in a lack of effective antibiotics and high medical expenses .', 'The resistance of pathogenic bacteria to antibiotics has become a serious problem .', 'Resistance of bacteria to beta-lactam antibiotics has become a serious problem in the past several decades .', 'The indiscriminate use of antibiotics fosters conditions that favor the selection of resistant microorganisms , suppressing at the same time susceptible forms , causing a serious problem in dairy cattle .']


Cluster  1262
['We attempted to taper off antipsychotics in 14\xa0weeks after which participants were free to restart.', 'A major problem with current anti-depressant therapy is that it takes on average 6 - 7 weeks for remission .', 'First episode major depression (DSM-III-R) outpatients who completed 6 weeks in two double-blind randomized trials with fluoxetine and desipramine were crossed over to treatment with the other drug under open conditions for 6 weeks.', 'After 4 weeks of inadequate response to escitalopram (10-20 mg/d), medication was switched to another 4 weeks of venlafaxine (VF, 150-375 mg/d) in 234 depressed patients.', 'Escitalopram has some unique features among selective serotonin reuptake inhibitors.', 'These data suggest that among first major depressive episode outpatients fluoxetine and desipramine are equally effective.', 'To determine the importance of individual characteristics and different therapy modalities in the occurrence of relapses.', 'In both genders, the psychopathological dimension that showed the most significant worsening at 6-month follow-up (i.e., anxiety in males and depression in females) was found to be a significant predictor of relapse at the 12-month follow-up.']


Cluster  2095
['Retrospective observational study including all patients with LN diagnosed between January 1993 and January 2014 in the only Nephrology Department of French Polynesia.', 'The annual incidence of SLE and LN in French Polynesia was 3.', 'Renal presentation was the main predictive factor for a renal response whereas geographical residence and maintenance-treatment regimen were predictive of LN relapses in patients from French Polynesia, an area characterized by a specific genetic background and including several isolated islands that have limited access to healthcare.']


Cluster  96
['The mean scores of preoperative depression and anxiety decreased postoperatively from 6.', 'The proportion of patients who experience anxiety prior to planned surgery, even a minimally invasive one, is estimated at 50-70%.', 'In the experimental group, the level of state anxiety at 48 h post-surgery was significantly lower than prior to the procedure, but only in subjects with preoperative trait anxiety Conclusion: Information support from a psychologist offered prior to a thoracic surgery decrease the level of postoperative state anxiety solely in children with lower levels of trait anxiety.', 'to investigate clinical and psychological outcome after surgery for LSS and the effect of depressive symptoms and anxiety on the clinical outcome.', "We have created the self-reporting 'Stress Questionnaire in Anaesthesiologists' (SQA), to qualify the sources of stress in anaesthesiologists' professional lives, and measure the level of associated stress.", 'Stress can negatively impact surgical performance, but mental skills may help.', 'SQA is a well adjusted measure for assessing stressors in anaesthesia physicians and includes clinical, organisational and team stress factors.', 'Surgical stress has been correlated with higher rate of postoperative complications.', 'In addition to analyzing the relationship between preoperative anxiety and depression according to the results of total knee arthroplasty (TKA), we will assess the evolution of anxiety and depression symptoms.']


Cluster  494
['Our results are similar to those previously reported.', 'All interventions produced significant hemodynamic responses compared to baseline.', 'Most women were very satisfied, predominantly with emotional support they received from the midwives.', 'Trabajadora de Salud was widely accepted by patients, caregivers, and health professionals.', 'Our results were similar to previous findings.', 'The volume-outcome relationship is well recognized.', 'All participants were able to perform the task-oriented training at their individualized intensity without any adverse effects.', 'SUI and TUI were similar for all tested outcomes.', 'Most participants successfully completed all trials without any discomfort.', "Peyton's approach is superior to standard instruction for teaching complex spinal manipulation skills regardless of gender."]


Cluster  1516
['Cure rate was 91% (10 of 11 patients, three females/eight males; mean age 59.', 'After 3 months of treatment, 87 of the 110 patients (79%) had responded (63%), which was considered excellent.', 'The majority of patients demonstrated either no change or minimally worse PGI-C in HS scores.', 'The rate of clearance plus marked improvement (favorable outcome) was 66.', 'At 1 year, 76 percent of the patients were satisfied with the outcome using this technique, although satisfaction had been 100 percent at 3 months.', 'In 13 patients, score was good or excellent.', 'At week 12, patients (n\xa0=\xa010) who reported being "very much improved" on the PGI-C had a mean 76.', 'Clinical improvement was observed in 100% of cases: total clearance in 41 patients (68.', 'The proportion of participants who reported receiving treatment after starting the study was 7.', 'The observed agreement rate between clinical and histological assessments of clearance of a single AK was 81·9% and the positive predictive value of a clinical assessment of clearance was 87%.', 'Among eight patients, three received "Almost clear" grade, the other five patients received "Marked improvement" grade at final visits.', 'Seven patients completed the evaluations at six weeks, six patients at three months.', 'Following the first ranibizumab injection, 58% of 84 patients gained five or more letters.']


Cluster  528
['The problem with the discrete case is that learning for one state does not improve learning with respect to other nearby states nor does it generalize to previously unseen states .', 'A major problem with learning a factorial model is that as the number of objects increases , there is a combinatorial explosion of the number of configurations that need to be considered .', 'Connectionist models with a backpropagation learning rule are known to have a serious problem .', 'A major drawback of artificial neural networks ( ANNs ) is their black-box character .', 'When compared to commonly used learning algorithms such as Perceptron and MIRA , the model trained by our algorithm performs consistently better when given the same amount of training time . the treatment of input elements as indivisible entities', 'When compared to commonly used learning algorithms such as Perceptron and MIRA , the model trained by our algorithm performs consistently better when given the same amount of training time . the treatment of input elements as indivisible entities']


Cluster  849
['HCV infected patients and healthy subjects were selected from the expatriate Egyptian population living in Qatar , where chronic HCV infection poses a serious health problem .', "These results show that hospital-based prevalence of HCV and HBV in Menoua Division is under the Cameroon 's national range but point out the fact that non-viral hepatitis might be a serious case of concern in this area .", 'Chronic hepatitis C ( HCV ) infection is a serious problem all over the world and has a special importance in Egypt , where the prevalence of infection is 14.7 % of population .', 'Viral Hepatitis B , C and D are a serious public health problem in Brazil and other South American countries , mainly in the Amazonian region .', 'On the last twenty years , viral hepatitis has emerged as a serious problem in almost all the Amerindian communities studied in the Amazon Basin and in other Amazon-related ecological systems from the North and Center of South America .', 'HDV infection still remains a serious public health problem in Amazonia .', 'Without hygiene education and HBV/HCV prevention , viral hepatitis infection will become a serious public health problem in Burkina Faso .', 'Hepatitis C virus ( HCV ) infection one of the most common blood-borne infections is endemic in Cameroon and a serious problem in hemodialysis ( HD ) .', 'Hepatitis-B infection is not commonly perceived as a serious medical problem in Nigeria .']


Cluster  1449
['Hypokalemia , serum potassium ( K ) < 3.5 mEq/L , is a serious and common clinical problem .', 'Iatrogenic hyperkalemia as a serious problem in therapy of cardiovascular diseases in elderly patients .', 'Hyperkalemia remains a vexing and challenging problem for clinicians , particularly in the management of patients with chronic kidney disease and congestive heart failure .', 'In addition , even though colonic K+ secretion increases in ESRD , interdialytic hyperkalaemia is a serious problem in haemodialysis patients , which might be reduced by stimulating colonic K+ secretion still further using laxatives .', 'Hyperkalemia remains a vexing problem for clinicians , particularly in the care of patients with chronic kidney disease and cardiovascular disease .']


Cluster  969
['This study could not confirm significant clinical improvement when using the product compared to the placebo, although its use was not associated with adverse effects.', 'Findings are consistent with those of a previous smaller, laboratory-based trial and provide support for the acceptability and effectiveness of MYLO delivered over the internet for a non-clinical sample.', 'At end point, (week 8) BPF supplementation significantly improved WCST "perseverative errors" (P = 0.', 'A randomized, placebo-controlled clinical trial was selected for critical appraisal.', '89 children received verum and 91 received placebo daily for 7 days (age groups 0.', 'For a drug to acquire Food and Drug Administration approval, it must significantly outperform placebo treatment.', 'The homeopathic syrup appeared to be effective in reducing the severity of cold symptoms in the first day after beginning treatment.', 'The primary and secondary efficacy endpoints consistently favored rupatadine 10 and 20\xa0mg doses over the placebo.', 'Although the primary efficacy end point was not demonstrated, consistent improvements in PEF and other clinical end points were observed with beclomethasone dipropionate BAI, particularly at the 80 μg/day dose.', 'Administering verum resulted in a statistically significantly greater improvement of the Cough Assessment Score than the placebo.', '24-month follow-up showed that Biodentine and MTA have similar effectiveness.']


Cluster  1573
['The contradictory views of care reveal a problem in the transmission of the definition of nursing to new generations of professionals and reflect a problematic professional reality where there is dissonance between how nursing is defined and how it is carried out in practice.', 'This study showed that novice students may not recognize the differences in acute and long-term nursing care.', 'The students demonstrated contradictory views of nursing care.', 'Students did not consider nursing to be an autonomous profession, although they highlighted its decision-making capacity.', 'Given the study results, there were no definitive educational recommendations to teach hand hygiene to nursing students.', 'One problem with the vocational model , as it has historically applied to nursing , is that it has been articulated through concepts of motherhood .', 'The problem with separating nursing care from personal care ( perspectives March 14 ) is that it overlooks that this is an artificial and unnecessary construct .', "The problem with nurses ' uniforms these days is that there is no uniformity nationally which identifies one grade from another ."]


Cluster  1455
['Baseline counts of MPAs with Mon2 subset (CD14++CD16+CC2+ monocytes) were significantly higher in patients with diffuse CAD compared to focal CAD (P = .', 'Monocyte-platelet aggregates with Mon2 are increased in patients with diffuse CAD and therefore could represent an important contributor to accelerated coronary atherosclerotic progression by a mechanism involving microvascular endothelial dysfunction.', 'Upregulated expression of CD86 on the intermediate subset (but not the number of intermediate monocytes) correlated with clinical severity as measured by PASI scores and serum beta defensin-2 levels.', 'These results suggest that the expression of CD86 on circulating intermediate monocytes could be used as an index in clinical practice and provide novel insights into how these cells join a complex immune network under the pathological conditions of psoriasis.', 'We evaluated the expression of functional markers on circulating intermediate monocytes.']


Cluster  688
['Even though heterotopic ossification ( HO ) is most often asymptomatic in patients after total hip replacement ( THR ) , it remains a serious problem in orthopaedics as it is observed in nearly all operated patients .', 'Osteolysis of the femur has been a serious problem associated with some designs of total hip-replacement implants ; it frequently leads to failure of the femoral component .', 'Implant separation from bone tissue , resulting in the necessity for revision surgery , is a serious drawback of cementless total joint replacement .', 'The wear rate of a larger 36-mm metal-on-XLPE articulation between 1 and 3 years following primary total hip arthroplasty was low and no greater than that of a 28-mm articulation.', 'This randomized trial suggests that unsupervised home exercise is both safe and efficacious for a majority of patients undergoing total hip arthroplasty, and formal physical therapy may not be required.', 'Impingement is a risk factor for instability and prosthetic failure following total hip arthroplasty (THA)', 'It has been suggested that cemented fixation of total hip arthroplasty (THA) is associated with an increased peri-operative mortality compared with cementless THA.', 'An additional, targeted mobilization and strength training of the hip muscles with full weight-bearing, which begins at the 3rd day after implantation of a THA is tolerated well and improves within one week hip range of motion and gait performance compared to standard physiotherapy.', 'Sixty-five individuals with primary hip osteoarthritis, scheduled for THA, were analyzed in this prospective intervention study.', 'Between September 2015 and April 2016, elderly patients who underwent bilateral hips replacement that met the inclusion and exclusion criteria were included in this study.', 'Fifty-six elderly patients undergoing primary total hip arthroplasty were randomized intraoperatively to receive either a 36-mm or 28-mm metal-on-XLPE articulation.', 'Increased blood loss remains a major drawback of simultaneous bilateral total hip arthroplasty ( SBTHA ) .', 'In clinical practice , femoral fractures occurring during cementless total hip arthroplasty are a serious problem , and use of a cemented prosthesis is recommended if rotational stability of the stem can not be ensured .']


Cluster  1319
['Childhood conduct disorders , a serious mental health concern , put children at risk for significant mental health problems throughout development .', 'Antisocial behavior emerges as a serious problem in young adolescents .', 'Patients with recurrent pathologic aggressive behavior constitute a severe problem for psychiatric institutions .', 'Agitation is a distressing and dangerous behavior for all involved.', 'Anger and anger regulation problems that result in aggressive behaviour pose a serious problem for society .', 'Even though this study focused only on serious incidents and defined recidivism narrowly , it found that recidivism of violence and aggression among psychiatric patients was a serious problem .', 'Aggression continues to be a serious problem among children , especially those children who have experienced adverse life events such as maltreatment .', 'Developmental behavioural disorders in early childhood are a serious public health problem , because they signify a higher risk of social , regulatory and emotional impairment in later life .', 'The collected data show that aggressive behaviors at work is a serious and challenging problem that may affect the performance and health of employees .', 'Antisocial personality disorder ( APD ) is a serious public and mental health concern .', 'Aggression in children and adolescents is a serious problem and is associated with various psychiatric disorders , not just conduct and oppositional defiant disorders , but in fact , most psychiatric disorders .', 'The pharmacological treatment of acute , persisting and repetitive aggression is a serious problem for other patients and staff members .']


Cluster  706
['Prospective and descriptive clinical study on 45 patients who underwent AOS procedures in the dental clinic of a public PHC of Spain between April and September 2015.', 'The occurrence of musculoskeletal pain in the upper extremities is a serious concern that affects Lebanese dentists .', 'Chronic pain in the orofacial region has always been a vexing problem for dentists to diagnose and treat effectively .', 'Sixteen patients with chronic drug-resistant neuropathic orofacial pain participated in this randomized controlled crossover rTMS study.', 'High prevalence of toothache ( more than half ) among residents of Kerman shows a serious and major public health problem .', 'The study had twin objectives : to assess the incidence of flare-ups ( a severe problem requiring an unscheduled visit and treatment ) among patients who received endodontic treatment in the Department of Conservative Dentistry and Endodontics in Vyas Dental college and hospital , Jodhpur during a period of one year , and also to examine the correlation with pre-operative and operative variables .', 'Most of the dentists working in Biscay routinely prescribe prophylactic antibiotics in conjunction with dental implant surgery among healthy patients.', '[ Oro-dental hygiene - a serious problem ] .']


Cluster  1888
['Trace element contamination caused by mining is a serious environmental problem .', 'Air quality in the mining sector is a serious environmental concern and associated with many health issues .', 'Former long-term mining and smelting of pollymetallic ores in the Middle Spiš area caused a serious contamination problem of the environment with heavy metals and metalloids , especially mercury ( Hg ) .', 'Heavy metal contamination via mining activity is a serious problem around the world .', 'Potentially toxic metals ( PTMs ) emission from coal mining and combustion are posing a serious public health concern .', 'Contaminated drainage from metal mines is a serious water-quality problem facing nations that exploit metal mineral resources .', 'Contamination of water resources by mine effluents is a serious environmental problem .', 'The occurrence of toxic metals and metalloids associated with mine tailings is a serious public health concern for communities living in mining areas .', 'Conclusion : This study shows that there is a serious problem of mercury contamination in gold mining regions of Antioquia , with significant involvement of the most vulnerable population .']


Cluster  376
['Urinary incontinence is a severe and common health problem .', 'Anal incontinence , as a result of traumatic lesions upon the anal sphincter , is a devastating problem .', 'Urinary incontinence is a debilitating problem that affects over 20 million people in the United States .', 'Randomized, single-blind (examiner), parallel study evaluating skin health effects in predominantly obese incontinent women normally using protective underwear (approximately 20% Type II Diabetes).', 'Prolonged postoperative incontinence is a major drawback of RRP .', 'Incontinence can be a devastating problem to many individuals .', 'Anal incontinence is a devastating affliction with several considerations that make it difficult to define in terms of epidemiology with good precision .', 'To determine the effect of bariatric surgery on urinary incontinence, dysuria, and fecal incontinence before and 1 year after bariatric surgery.', 'Urinary incontinence , although not life threatening , can be a distressing problem with a profound impact on quality of life .', 'The prevalence of coital intercourse in urinary incontinence women was high.', 'Severe fecal incontinence is a serious problem not only for the patient whose quality of life is diminished , but also for the surgeon , who sometimes has difficulties how to manage all the aspects of this complicated condition .', 'Incontinence is a distressing , complex health problem which disproportionately affects older people .', 'Sixty-five percent of patients using pads considered urinary leakage to be a problem , but only 1 considered it a serious problem .', 'Recurrent stress urinary incontinence is a distressing problem .', 'The aim of this study was to determine whether the clinical response to the radiofrequency energy procedure is superior to sham in patients with fecal incontinence.', 'However , only 24 % of the stress incontinent and 28 % of the urge incontinent patients found their incontinence to be " quite a problem " or " a serious problem . " Patients leaking urine only " occasionally , " " once a week , " leaking " drops , " and finding the leakage to be " a bit of a problem " had median leakage 0 g during ST and 24hPT .', 'Anorectal strictures have been a serious problem for many years .', 'Urinary incontinence is a serious problem for many women .', 'For a limited group of people , urinary incontinence is a severe problem .', 'Urinary incontinence is a debilitating problem that requires careful evaluation .', 'Stress urinary incontinence ( SUI ) is a serious problem in women who have delivered vaginally , and causes some sexual dysfunction .']


Cluster  1188
['The disease with active epithelial inflammations , corneal ulcers , including loss of the visual acuity is a serious medical problem as an emerging threat for the public health related to improper contact lens hygiene .', 'Contact lens-acquired bacterial infections are a serious problem .', 'With about 50 - 60 million cases in the US alone , dry eye disease represents a severe health care problem .', 'Ocular infections are a serious public health problem in Ethiopia with increased incidence of morbidity and blindness .', 'Conjunctival fibrosis is a serious clinical concern and is associated with chronic inflammation of the ocular surface tissue , such as in allergic eye disease .', 'The carriage of pathogenic organisms to eyes through the agency of eye drops has presented a serious problem for several decades .', 'Post-traumatic endophthalmitis associated with penetrating injury represents a distinct kind of intraocular infection and is still a severe problem for diagnosis and treatment in developing countries .', 'Ophthalmic mycoses caused by infectious fungi are being recognized as a serious concern since they lead to total blindness .', 'Subsequent opportunistic infections of ocular tissues , such as CMV retinitis , are a serious problem in clinical ophthalmology all over the world .', 'However , endophthalmitis still represents a serious clinical problem .', "However , the extensive use of S-1 in clinical practice results in watery eyes , a serious clinical problem , which worsens patients ' quality of life .", 'Bacterial superinfections were a serious problem , with a total of six superinfections occurring in three treated eyes .', 'Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness', 'This was a prospective clinical study on 16 consecutive patients (16 eyes) with refractory uveitis-associated CME.', 'Orthokeratology-associated infectious keratitis continues to be a serious problem , especially in regions with high prevalence of myopia .']


Cluster  1630
['Among the 400 endotracheal tube cuff pressure measurements (25 patients×16 positions) 10 (2.', 'Peak, plateau and mean pressures were significantly lower during the intense and deep blockade.', 'Joints withstand huge forces, but little is known about subchondral pressures and perfusion during loading', 'All bandages showed pressure losses after 1\xa0h; 82.', 'In the in vitro phase, the intracuff pressure was 45 ± 6, 23 ± 1, and 14 ± 6 cmH<sub>2</sub> O with size 4.', 'The current study measures intracuff pressure with different-sized cuffed ETT.', 'The cuff pressure was higher in the TaperGuard ETT than in the cylindrical ETT after positional change of head from neutral to lateral rotation.']


Cluster  1674
['MFRS is an effective method to improve skin laxity.', 'Our data show significant improvement of skin texture, skin laxity and wrinkle reduction achieved using RF treatment platform.', 'Determine the effectiveness of this new TF in reducing superficial face wrinkles and restructuring the dermal matrix.', 'We evaluated the efficacy and safety of HIFU for skin tightening in the face and body.', 'To compare the efficacy and safety of two HIFU devices for facial skin tightening and subsequently, to validate the quantitative assessment.', 'Our prospective and randomized study has shown that the new TF is safe and effective in reducing superficial face wrinkles and producing dermal regeneration.', 'To compare the efficacy and safety of SMRF and MFU-V for the lifting and tightening of neck.']


Cluster  1938
['Severe , multitissue hand injuries constitute a serious problem of the modern world .', "To examine hand injury patients' experiences during early recovery to illness perceptions, disabilities, and quality of life and to identify predictors of quality of life at 1 month and 3 months after hospital discharge.", 'However , to those who have lost their arms and hands due to accident or war , touching becomes a serious concern that often leads to psychosocial issues and social stigma .', 'Mutilating hand injuries in children are a devastating problem .', 'This prospective observational study of hand injury patients was performed at a teaching hospital in Taiwan.', 'To observe the effect of a rehabilitation intervention on the comprehensive health status of patients with hand burns.']


Cluster  2151
['A total of 117 lesions (28 nodules and 89 fistulae) were treated in 42 patients.', 'The mean counts of comedones, papules, pustules, and nodular lesions decreased significantly (all P<.', 'There was a high prevalence of tracheal lesions, mainly subglottic granulomas.', 'A total of 120 lesions were treated.', 'Induction chemotherapy resulted in eradication of nodules in 26, residual nodules in 33, and early treatment-related death in one.', 'We examined 579 patients with 649 lesions; 32 (5.', "The lesions' frequency were: pyogenic granuloma (48%), followed by venous lake (17.", 'Ten of fourteen lesions responded with necrosis, a decrease in size and/or pain, and histological clearance on MMS.']


Cluster  2069
['In a 24-month prospective observation study, patients with non-syndromic mild hypodontia manifested with missing teeth in the anterior maxilla were included.', 'Although hypodontia does not represent a serious public health problem , it may cause masticatory and speech dysfunctions and esthetic problems .', 'Although hypodontia does not represent a serious public health problem , it may cause masticatory and speech dysfunctions and esthetic problems .', 'The results of this study observed a higher prevalence of hypodontia compared to previous studies conducted on the Italian population.']


Cluster  1002
['This study assists in closing the research-practice gap by using tailored, multifaceted implementation strategies to increase use of evidence-based nursing care for infection prevention practices.', 'This quasi-experimental study used a convenience sample of 42 third-year baccalaureate nursing students.', 'Undergraduate nursing students (n\xa0=\xa0127) were randomized into treatment and control groups.', 'The aim of this research study was to assess the effect of a peer education program about combating VAW on the knowledge, attitudes and skills of nursing students.', 'A study design involving cross-sectional surveys of five cohorts of nursing students in a baccalaureate nursing program was implemented.', 'Participants were taken from a convenience sample of 131 undergraduate nursing students enrolled in a nursing fundamentals course at an urban university in the midwestern United States, and then randomly assigned to their respective groups.', "A 2-group posttest design was used to examine the effect of the VAP-prevention guidelines education on nurses' compliance.", 'Thirty undergraduate nursing students volunteered to participate in this study.']


Cluster  434
['Patients with advanced unresectable or metastatic biliary tract cancer starting first-line chemotherapy with gemcitabine plus cisplatin underwent F-FDG PET-CT studies at baseline and after two cycles of therapy.', 'An elevated preoperative NLR predicts poor prognosis in T1 esophageal cancer, suggesting the utility of the NLR as an easily measurable and generally available independent prognostic marker.', 'We carried out a prospective study to evaluate the prognostic role of fluorine-18 fluorodeoxyglucose (F-FDG) PET-CT scans in patients with advanced biliary tract cancer.', 'Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results.', 'Lower baseline TLG measured by F-FDG PET-CT as well as a decrease in metabolic uptake after chemotherapy were associated with a trend toward longer median survival among patients with advanced biliary cancers.', 'Compared with conventional tumor stages, our nomogram-based P-risk Plus model for gallbladder adenocarcinoma has a better predictive capacity and thereby has a better potential to facilitate decision-making clinically.']


Cluster  587
['PDT treatment can effectively eliminate HPV, significantly reducing viral loads after three rounds of treatment (p\u2009<\u20090.', 'To evaluate resource use and costs in women with HPV-related lesions.', 'A retrospective study using insurance claims databases was performed to assess the annual medical cost for suspected cervical intra-epithelial neoplasia (CIN)/CC, genital warts (GWs), CIN (all grades), and CC.', 'HPV-related pathologies in HIV-infected men are a serious concern .', 'Uptake of human papillomavirus (HPV) vaccination is suboptimal among some groups.', 'The Pap smear has an important value in the early diagnosis of cervical cancer , a serious problem in womens health .', 'To describe the epidemiology, natural history and risk factors associated with oral HPV infection in asymptomatic young adults.', 'The first publication that associated Human Papillomavirus (HPV) infection and esophageal cancer was published in 1982', 'HPV infections did not affect the discrepancy between smear-biopsy ( p = 0.533 ) , smear-LEEP ( p = 1.000 ) and biopsy-LEEP ( p = 0.529 ) CONCLUSIONS : Smear technique has a serious discrepancy and under-diagnosis problem when its results are compared with biopsy and LEEP .', 'Oral HPV infection is transient and is associated to same-gender relationships, mainly women who have sex with women.', 'Human papillomavirus infection risk was 20.', 'ALA-PDT can effectively eliminate latent or subclinical HPV infections.', 'Infection with HPV , particularly HPV16 , remains a serious health problem due to its major risk factor contributing to cervical cancer .', 'The human papilloma virus is the leading cause of anal squamous cell carcinoma.']


Cluster  414
['Compared to right hemihepatectomy, anatomic trisegmentectomy in right liver guarantees the maximum preservation of %FLRV to increase the resectability of huge or multiple HCC, thus improving the overall resection rate.', 'Eligible LSH patients (n\u200a=\u200a62) scheduled for open left lateral segmentectomy or left hemihepatectomy with intraoperative biliary exploration via the left hepatic duct orifice (LHD group, n\u200a=\u200a35) or the common bile duct (CBD group, n\u200a=\u200a27) were retrospectively studied.', 'Laparoscopic hepatectomy is safe and feasible for the treatment of patients with large HCC.', 'A management algorithm including both endoscopic treatment and oesophagectomy provides optimal outcome for these patients.', 'Patients with a solitary HCC (diameter 5-10\u2009cm) who underwent open or laparoscopic hepatectomy were enrolled in a prospective observational study from January 2012 to April 2015.', 'This study included 16 patients who underwent open hepatopancreatobiliary surgery between March 2011 and March 2012.', 'For left-sided hepatolithiasis patients with a history of biliary tract surgery, LHD cholangioscopy is an accessible technique that simplifies the operation procedure by avoiding choledochotomy and subsequent T-tube insertion, which results in lower complication rates as well as shorter operative duration and length of hospitalization.', 'A total of 360 cases with hepatoblastoma were enrolled.', 'Minimally invasive esophagectomy is feasible in patients with liver cirrhosis.', 'Liver steatosis, as measured by ultrasonography, improves after sleeve gastrectomy, achieving a complete resolution in 90% of the cases.', 'Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is performed as an alternative to the percutaneous or surgical approach.']


Cluster  1841
['Counterfeiting of pharmaceuticals has become a serious problem all over the world , particularly in developing countries .', 'Counterfeiting has become a serious and underreported problem in the pharmaceutical industry .', 'Counterfeit drugs are a menacing and deadly problem worldwide .', 'Pharmaceutical counterfeiting is becoming a serious problem in the world , especially in developing countries including China .', 'Counterfeit medicines are a serious public health problem in Peru .', 'Counterfeit medicines have become a serious global problem .', 'Pharmaceutical counterfeiting is becoming a serious problem both in developed and developing countries .']


Cluster  1070
['Mean iCa during procedures was significantly different in the two groups (1.', 'Statistically different early and late complications were recorded among the different IPAA techniques.', 'IPI was successfully recorded on 62 subjects (48 successful and 14 failed extubations).', 'Technical improvements changed the IPAA technique.', 'Declining IPI measurements postextubation are predictive of extubation failure.']


Cluster  1384
['AKI occurred in >10% of patients after SAH.', 'One hundred and seventeen cases of AKI-MALA-RRT were observed (12.', 'It is therefore not surprising that akathisia is generally either underdiagnosed or misdiagnosed , which is a serious problem because it can lead to such adverse outcomes as poor adherence to medications , exacerbation of psychiatric symptoms , and , in some cases , aggression , violence , and suicide .', 'Despite that , it should be noted that CIAKI poses a serious health problem because it is a very common cause of hospitalacquired AKI , linked to increased morbidity and mortality and utilizing growing healthcare resources .', 'In part , the problem with AKI is that it has historically been regarded as little more than a sequal to other more pressing physical illnesses and therefore not taken as seriously as it might .', 'This study was limited by a small sample size and a high dropout rate, as well as the lack of a standardised scoring system for AKN.', 'Twenty-nine patients (60%) developed AKI during the first five postoperative days, without need for dialysis.', 'CI-AKI was seen in 85 patients (4.', 'AKI incidence was up to 15% during hospitalization.', 'We randomly assigned 86 patients with KS to a UGPN group or a control group, each group comprising 43 patients.', 'Improvements in patient counselling at the primary care centre are needed before the implementation of TD as a routine methodology for the management of AK.']


Cluster  111
['One hundred eighty-five consecutive patients with RA who underwent both cervical plain radiography and bone mineral density (BMD) scanning were enrolled.', 'Cervical spondylotic radiculopathy (CSR) is a relatively common neurological disease caused by the mechanical compression of nerve roots.', 'Lumbar radiculopathy refers to the disruption of one or more lumbosacral nerve root functions, usually causing radiating pain and functional impairments.', 'We conducted a prospective observational study in which MRI findings were correlated with corresponding findings on hip arthroscopy in a cohort of 25 patients of active LCPD below 12\xa0years of age.', 'MRI cannot be completely relied upon for identifying all the intra-articular pathologies in children with LCPD, although it has a good complimentary role.', 'A clinically evident radiculopathy without correlation in the imaging studies represents a serious problem regarding the indication , planning and execution of an operative procedure for its treatment .', 'A possible drawback of RAD is that some rare but clinically relevant abnormalities may be missed .', 'We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018.']


Cluster  1704
['The problem with single-exposure technique is that a good exposure of the hip overexposes the lower leg .', 'The comfortable self-selected walking speeds of some subjects were higher with i-KNEE while some were not.', 'Thirty-four young women who demonstrated dynamic knee valgus during step-down were divided into two groups.', 'The footrests at 10% and 15% of the body height caused a lower change in the median frequency ratio and the muscle activity ratio than the other conditions.', 'A kneeling posture can provide higher rate of CC than a standing posture can (111.', 'A better location would be the wrist but with the drawback of the presence of perturbative movements independent of walking .', 'Group 1 had 10 unbalanced knees in the final pressure difference assessment, while all cases in group 2 were balanced (P < 0.', 'An acute session of static stretching with or without vibration immediately before performance does not alter jump height.', 'During forward transfer, the knee extension and hip flexion decreased in the CG after perturbation compared to NCG, and the trunk extension angle increased.', 'Hip and trunk strengthening reduced lower limb adduction during step-down.']


Cluster  523
['Aggressive behaviour exhibited by domestic pigs following encounters with unfamiliar individuals is a serious welfare and economical problem .', 'Abscesses of odontogenic origin in guinea pigs pose a serious health problem and need to be treated with a combination of surgical and medical therapy .', 'HEV was widespread in commercial swine population in Eastern and Southern China that raised a serious concern about the safety regarding the consumption of pork products .', 'Pork contamination is a serious concern for the global halal food market because many manufacturers commonly use pork instead of beef to reduce production costs .', 'Antimicrobial therapy is a curative treatment for piglets infected with STEC , but the emergence of antimicrobial-resistant STEC has become a serious problem for Japanese pig farmers .', '[ Endemic viral diseases : a serious economic problem in the Japanese pig industry ] .', 'Polymerase chain reaction ( PCR ) is so far the only suitable method to diagnose a cross-species transfer of PERV , but the exclusion of microchimerism might be a serious problem because most of the presently employed primer pairs detect PERV sequences with higher sensitivity than primers used for the detection of contaminating pig sequences .', 'Infection of laboratory mice with Helicobacter spp . is a serious problem for many laboratory animal facilities worldwide .', 'Taken together with our previous results , it appears that paragonimosis is a serious problem in boar-hunting dogs .', 'Streptococcus suis infections are a serious problem for both humans and pigs worldwide .']


Cluster  2299
['Faecal incontinence is a distressing and embarrassing problem that can have a profound affect upon quality of life .', 'Faecal incontinence is a distressing problem that is often not amenable to surgical correction .', 'Faecal incontinence is a devastating social and hygiene problem , impacting heavily on quality of life and ability to work and socialise .', 'Faecal incontinence is a debilitating problem with significant medical , social and economic implications .', 'Fecal incontinence is a debilitating problem that has many different causes .', 'Fecal incontinence represents a devastating problem that often prevents a patient from becoming socially accepted and may cause serious psychological sequelae .', 'Faecal incontinence is a distressing and socially debilitating problem .', 'Faecal incontinence is a debilitating problem with significant medical , social and economic implications .', 'Fecal incontinence is a serious problem that may lead to social segregation and psychological problems .']


Cluster  685
['The short-term effects of high temperatures are a serious concern in the context of climate change .', 'However , this wavelength overlaps with the absorption peak of water that is dominant in the biological environment , eliciting a serious biological heating problem .', 'Heat stress can be a serious problem in aircraft flown at low altitudes in warm-to-hot environments .', 'We calibrated and compensated for the air convection at elevated temperatures , which is a serious problem for optical techniques .', 'A common problem with these experiments is that the photodegradation experiments are done at higher than ambient temperature .', 'The urban heat island effect has become a serious environmental problem with the expansion of cities and industrial areas .', 'However , a serious problem that can arise is an error in the retrieved brightness temperature from a higher threshold level owing to the presence of RFI .']


Cluster  589
['In children with SAR, BHS is effective in improving nasal symptoms and NCC, with an associated beneficial effect on quality of life.', 'In this clinical trial, double-blinded study, 70 patients with nasal polyposis who have indication of FESS were enrolled to this study.', 'Adults treated with resveratrol or budesonide achieved a significant reduction in nasal symptoms compared to the placebo-treated group.', 'The objective of this clinical trial (CRS-02) was to assess the efficacy, safety and tolerability of two dosages of the herbal medicinal product BNO 1016 (Sinupret extract) in patients with chronic rhinosinusitis (CRS).', 'Nasal cycle can be easily assessed by means of PNIF.', 'The problem with empty nose syndrome is probably not that it does not exist , it is that we can not adequately explain its existence by what we currently understand about the nose .', 'Bacterial lysate used in the remission period of rhinosinusitis in children was shown to provide long-term prophylaxis.', 'Recurrence of the nasal polyposis is prevalent and a severe problem .', 'Improvement in health care of the young and antibiosis militate against tonsilloliths as a serious problem in the young patient .', 'In the study of inflammatory mechanisms in the upper respiratory tract , the unknown dilution of collected samples of nasal secretions poses a serious problem for interpretation of the measured concentrations of various substances in the specimens .', 'Median rhinophyma severity index scores of patients at first visits were significantly higher than those at second and third visits ( P = .', 'Participants performed daily betamethasone nasal irrigation for six weeks.', 'Data and photos of 13 patients were retrospectively evaluated and scored via 2 different forms of the rhinophyma severity index.', 'Fifty patients with bilateral chronic rhinosinusitis with nasal polypi were operated with 100 surgical cavities.', 'At one year of follow up, the visual analogue score, nasal discharge and obstruction scores, number of days with rhinitis attacks per month and number of days with antibiotic use per month were significantly decreased in the prevention group versus the control group (p < 0.', 'Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in Germany and is often accompanied by years of chronic rhinosinusitis.']


Cluster  1882
["An equivalent notation , using the Xerox `` contain '' operator -LRB- $ -RRB- is $ -LSB- ^ Art : * `` Indef -RSB- . they require an exact match of the constituents in extracted phrases , so it faces the risk of losing coverage of the rules", "An equivalent notation , using the Xerox `` contain '' operator -LRB- $ -RRB- is $ -LSB- ^ Art : * `` Indef -RSB- . they require an exact match of the constituents in extracted phrases , so it faces the risk of losing coverage of the rules"]


Cluster  188
['Pre-post differences were significant and there was no evidence that treatment was differentially effective for general and disorder specific symptoms.', 'Analyses detected no notable between-group differences at either pre- or post-intervention testing.', 'Our study showed no significant improvement in diagnostic thinking abilities or knowledge exam results with the use of VP.', 'There were no significant differences between experiment and control group in the indexes, including FMA, WMFT, and MBI scores, before the intervention.', 'No significant effects on cognitive parameters were found.', 'There was no control group including an active psychological intervention, the sample was small, and emotional congruence was not assessed within persons.', 'The severity of UI showed a trend, albeit non-significant, toward improvement in both groups.', 'No significant differences were found by drug treatment or sequence of treatment.', 'No significant differences were found in attention and mood after the NRE intervention compared with the control intervention among the HF patients and the healthy adults.', 'No significant differences were found in the assessment made before intervention.', 'There were no statistically significant differences between the 2 groups (integrated model on the DEU compared with a traditional experience on an acute care and inpatient behavioral health unit).', 'No significant difference in the incidence of headache among the three groups was detected.', 'The two groups had no significant differences in the scores of knowledge, HBM constructs, or behavior before the intervention.', "The follow up assessment didn't show statistical significant difference between the two groups regarding the incidence of UTI.", 'Overall, repetition of Clinical Pearls did not statistically improve test scores amongst junior and senior residents.', 'No statistically significant differences were observed between the experimental and control groups regarding sociodemographic characteristics, medical and surgical information.', 'Regression analyses revealed no significant change over the two years, including post-study follow-up.', 'There were no statistically significant differences in student knowledge and self-confidence between face-to-face and virtual clinical simulations.', "No significant difference was observed in the patients' levels of anxiety, systolic blood pressure, diastolic blood pressure, respiratory rate, and pulse rate before the intervention.", 'No significant differences in treatment success were found among the four groups.']


Cluster  1609
['Exposure to traumatic experiences among youth is a serious public health concern .', "Young people 's fears of victimization and feelings of unsafety constitute a serious and pervasive public health problem and appear to be associated with different factors than actual victimization .", 'Exposure to adversity and toxic stress in childhood is a serious public health problem .', 'Peer victimization in children and adolescents is a serious public health concern .', "The results from 80 assessments showed that children's behavioral signs differed significantly between painful and calm situations (p\xa0<\xa00.", "We investigated spontaneous injury talk among parents and children in the aftermath of a child's hospitalisation due to physical trauma, and its relationship with children's socioemotional functioning."]


Cluster  2382
['This was a retrospective cross-sectional study of syphilis screening and confirmatory test results of blood donors that were obtained before and after adopting a chemiluminescent immunoassay (CLIA).', 'Syphilis transmission among IDUs in Los Angeles County remains a serious public health concern , particularly among IDUs who engage in trading of sex for money or drugs .', 'This study illustrates that , despite being a preventable infection , syphilis remains a public health problem .', 'Syphilis continues to be a serious public health problem worldwide , even if it is a controllable disease due to diagnostic tests and effective and accessible treatment .', 'Congenital syphilis is the oldest recognized congenital infection and still represents a serious healthcare problem in the 21st century .', 'Persistent syphilis in this population of FSWs is a serious public health concern .']


Cluster  1116
['Anti-vascular endothelial growth factor ( VEGF ) agents have been used for the last 10 years , but their safety profile , including cytotoxicity against various ocular cells such as retinal pigment epithelial ( RPE ) cells , remains a serious concern .', 'VEGF levels were significantly higher in stable asthmatic patients and even more so in acute asthmatic patients, compared to healthy controls.', 'Vascular endothelial growth factor (VEGF) is an important mediator of angiogenesis.', 'Compared to normal control patients, the serum levels of VEGF were elevated in stable asthma patients and even more elevated in patients with acute exacerbation.']


Cluster  1403
['Drought-induced tree death has become a serious problem in global forest ecosystems .', 'The increasing occurrence of forest ecosystem degradation is a serious problem in tropical and subtropical regions .', 'Bark beetle infestation and associated fungal infection are a serious disease problem in conifer species .', 'Sadly , many of the tropical forests of the world are under severe environmental pressure , and deforestation is a serious problem in most tropical countries', 'Land degradation is a serious problem in tropical mountainous areas .']


Cluster  607
['We generalize here a previous notion of ergodic sets , and we show that the Threshold Ergodic Sets so defined are robust with respect to noise and , at the same time , that they do not suffer from a major drawback of ergodic sets .', 'To testify this , we need a diversity metric . the combinatorial expansion in the search space', 'One possible objection to this comparison is that the subset for which we have a fair compar the system having an unrealistically high memory requirement', 'A resulting limitation is that the bound is loose in many cases', 'We counter the problem of a large parameter space', 'The results indicate that the collinearity might be a serious problem in the applications of the topological indices .', 'Di Eugenio raised the issue of the effect of skewed distributions on the value of K', 'To solve the problem of high dimensionality', 'A serious limitation of both π and κ is that all disagreements are treated equally']


Cluster  1608
['Out of 94 patients with cutaneous sarcoidosis, we identified 12 patients (12.', 'Fatigue in patients with sarcoidosis in clinical remission is a frequent symptom and can be characterized as a severe and long-lasting problem , symptomatically similar to CFS .', 'Sarcoidosis before and after treatment of malignancy is an important differential diagnosis that has to be distinguished from lymphoma', 'The diagnostic yield and specimen adequacy were not different when EBUS-TBNA was performed with 10 or 20 revolutions in subjects with sarcoidosis.', 'This observational cohort prospective study included all patients diagnosed as cutaneous sarcoidosis.', 'Consecutive patients with biopsy-proven sarcoidosis undergoing CMR were retrospectively evaluated for cardiac sarcoidosis.', 'The detected increase in the total number of deaths and age-adjusted rates of sarcoidosis deaths in the U.S. is a serious health concern .', 'To determine the clinical and histological features, demographic characteristics, and prognosis of patients diagnosed with paraneoplastic sarcoidosis (PS).', 'Pulmonary sarcoidosis is often complicated by pulmonary hypertension, a complication that is associated with increased disability and mortality', 'Using CMR, we identified a higher prevalence of cardiac sarcoidosis than previously reported clinical studies, a prevalence which is more consistent with autopsy data.']


Cluster  1011
['Twenty patients underwent PDT and 22 underwent TTT.', 'Both THD and TST are safe, and they appear to have similar short-term outcomes; however, TST is associated with better improvement in symptoms, lower recurrence rates and greater patient satisfaction.', "Following PDT, patients showed a significant attenuation in symptoms' intensity (itching, pruritus, vulvar discomfort).", '1) Explore the safety and feasibility of a 10-week DT program for PD.', 'A major drawback of PDT is pain during treatment that can cause extreme distress for some patients .']


Cluster  451
['We identified 53,746 patients who underwent open repair, 53,282 (99.', 'In total, 28 patients underwent the procedure so far.', 'Thirty-nine patients were enrolled, 19 to sutureless and 20 to sutured repair.', 'We observed a total of 244 surgeries for SSCL compliance.', 'Ninety-four patients were included; 48 were allocated to the plug procedure and 46 to advancement flap surgery.', 'To better understand the relationship between surgeon-specific characteristics and the number of Mohs micrographic surgery total cases, stages per case, number of grafts, and number of flaps performed by each surgeon.', 'A total number of 108 endovascular procedures were performed (mean 2.', 'Between January 1, 2009, and April 30, 2017, 102 procedures and 36 acute and 66 elective repairs for PAA were identified.', 'Procedure data of 59 early-career, mid-career, and advanced-career Mohs surgeons were obtained from the website of the Centers for Medicare & Medicaid services.', 'A total of 209 infections were included (99 with double-J, 81 with nephrostomy, and 29 with internal/external nephroureteral stents).']


Cluster  1890
['The incidence of anaphylaxis is higher in children than previously reported in adults from the same center, and food is the trigger in most cases.', 'Food allergies are a serious and rising public health concern .', 'Food allergy is a serious problem affecting a growing number of children worldwide .', 'Parent-reported food allergy could put caregivers under high stress, but the OFC test could reduce stress among anxious, over-parenting caregivers.', 'Although relatively infrequent , meat allergy represents a serious problem for children both because it is generally associated with intolerance to other protein sources and because of the suggested role of meat in stimulating the gastrointestinal development during weaning .', 'Childhood food allergy is a serious health problem .', 'This study aimed to evaluate the caregiver quality of life (QoL) and growth in children with a parent-reported food allergy.', 'Food allergy has become a serious health concern especially in developed countries in the past two decades .', 'Food allergy is a serious health problem for which a validated outbred large animal model would be useful in comparative investigations of immunopathogenesis and treatment and in testing hypotheses relevant to complex host-environmental interactions in predisposition to and expression of food allergy .', "Prevalence and severity of cow's milk protein allergy (CMA) in infants are increasing.", 'A major drawback of oral immunotherapy for food allergy is the possibility of severe side-effects .', 'Cow milk allergy (CMA) is the most common food allergy in breastfed infants.', 'Food allergy is a serious food safety problem worldwide , and the investigation of food allergens is the foundation of preventing and treating them , but relevant knowledge is far from sufficient .', 'Food allergy is a serious problem for infants and young children .', 'Food allergy ( FA ) is a serious health problem , and severe FA such as food-induced anaphylaxis can often be life threatening .', 'Some caregivers who believe their children have food allergy avoid feeding certain foods to their children without proper allergy tests.', 'Although food allergy is a serious health problem in westernized countries , factors influencing the development of food allergy are largely unknown .']


Cluster  1949
['Observational service level evaluation of 112 patients comparing baseline of AO care with each year of routine care subsequent to the team closure.', 'Data showing the number of AOM diagnoses, ventilation tube insertions, myringotomies, acute mastoiditis cases and mastoidectomies between 2005 and 2014 were extracted from the National Board of Health and Welfare database.', 'AO patients are remarkably resilient to substantial reductions in the intensity of care.', 'This is a retrospective observational analytical case-based study involving all consecutive patients under the age of 18 years old presenting with AOE to a pediatric emergency department.', 'AOM incidence decreased, both in outpatients (39%) and hospital admissions (42%).']


Cluster  1599
['Burn infection is a serious problem that delays wound healing and leads to death .', 'Fungal infection in severely burned patients is a serious problem due to various factors , such as the extensive application of antibiotics .', 'Drug resistance to antibiotics is a serious problem in a burn unit , calling for monitoring the vicissitude of bacteria strains and antibiotics sensitivity in order to control bacterial infection and dissemination .', 'In conclusion , K. pneumoniae is becoming a serious problem in burn patients .', 'Despite the fact that advances of burn treatment have led to reduction in the morbidity caused by burns , burn infection is still a serious problem .', 'The emergence of multi-drug resistant strains of P. aeruginosa is a serious concern in burn patients who are hospitalized in Tehran .', 'On the other hand , the management of these conditions is a serious problem , especially in critically ill patients with multiorgan failure , including severely ill burn patients due to the shortage of available antifungal agents .']


Cluster  35
['It can be estimated that , in general , 3 of 4 men presenting with intermittent claudication will never have a serious problem necessitating vascular intervention , and that no more than 5 % are ever likely to require a major amputation .', 'Retrospective analysis of successfully reperfused MCA occlusions (n=246) with available angiography runs between every manoeuvre was performed.', 'Cannulation of the internal jugular vein may be associated with inadvertent puncture of the common carotid artery.', 'Injury to the iliac vessels poses a serious and frustrating treatment dilemma for all trauma surgeons .', 'Acute left main coronary artery occlusion : a catastrophic problem with poor prognosis .', 'We present the case of a young ischemic stroke patient with middle cerebral artery (MCA) occlusion and spontaneous recanalization.', 'Errant embolization occurred in one patient but did not become a serious problem .', '4 . There was no evidence of troble due to a generally raised pressure in the arm veins nor was clotting in the cannula a serious problem .', 'Sixty-eight participants correctly identified the puncture site and performed IO cannulations.']


Cluster  642
['The suprapectoral two-stage expander/implant reconstruction without acellular dermal matrix in nipple-sparing mastectomy has certain advantages with respect to breast shape, less morbidity related to expansion, ease of reconstruction, and cost effectiveness.', 'Tuberous breast (TB) is a rare congenital deformity, which may appear in different clinical forms representing various degrees of a single pathological entity.', 'Between April of 2013 and July of 2014, in Rosario (Sanatorio de la Mujer and Centro Quirúrgico Rosario), Argentina, a prospective cohort study of women with and without breast implants was performed.', 'Seventy-five patients undergoing primary breast augmentation had a round silicone implant of optimal volume, projection, and diameter placed in one breast and an anatomical silicone device of similar volume and optimal shape placed in the other.', 'No observable difference in breast aesthetics between anatomical and round implants was reported by plastic surgeons in 43.', 'This study provides high-level evidence supporting no aesthetic superiority of anatomical over round implants.', 'The aim of this article is to share our initial experience using the lower pole subglandular advancement mastoplasty (LOPOSAM) technique to reshape the breasts in MWL patients and to elaborate the technical details and simplicity of the method in the attached video.', 'Fifty-one mastectomy patients (one double sided), who required delayed implant reconstruction, with poor skin conditions were proposed fat grafting prior to implant reconstruction.', 'Primary mastopexy using the buttonhole technique performed together with nipple-sparing mastectomy is a safe procedure with predictable results in patients with very large or ptotic breasts requiring lifts greater than 6 cm.', 'This study shows that most patients with breast implants were able to establish breastfeeding.', 'A total of 114 parturients with inverted nipples who gave birth in the Drum Tower Hospital Affiliated to Nanjing University School of Medicine from October 2018 to October 2019 and successfully breastfed in the hospital were selected.', 'From July of 2012 to January of 2014, 11 consecutive patients underwent a central mound mastopexy with soft-tissue reinforcement in the lower pole using a poly-4-hydroxybutyrate resorbable scaffold.']


Cluster  1386
['We have previously documented blinding trachoma to be a serious public health problem in Southern Sudan , with an unusually high prevalence of trachomatous trichiasis ( TT ) among children .', 'Although facial cleanliness is part of the SAFE strategy for trachoma there is controversy over the reliability of measuring a clean face', 'Trachoma is a serious public health problem in rural Ethiopia .', 'Trachoma is a serious public health problem in Mankien , and the high prevalence of trichiasis in children underscores the severity of blinding trachoma .', 'In Brazil , trachoma appears to be a serious public health problem in indigenous settlements , which should therefore be given priority in programs aimed at the elimination of trachoma in the country .', 'Trichiasis recurrence following surgery is a serious problem for trachoma programs .', 'Trachoma is a serious public health problem in Menofiya governorate and a significant contributor to vision loss .']


Cluster  1160
['An emollient bathing product can be effective for Malassezia overgrowth in dogs with atopic dermatitis.', 'Sixteen atopic dogs with secondary Malassezia overgrowth and 11 healthy dogs.', 'Daily topical application of the test solution was effective in reducing the Malassezia burden, as well as improving clinical scores in dogs with MAD of the paws.', 'There was a statistically significant reduction in Malassezia numbers and clinical scores for paws treated with the test solution versus placebo.']


Cluster  2293
['Currently , coagulase negative staphylococci ( CoNS ) have got much attention as a serious health problem especially in neonates and children .', 'Nosocomial infections due to staphylococci continue to pose a serious health concern worldwide .', 'At that time , penicillinase-producing Staphylococci were causing a serious problem in hospitals .', 'Staphylococcus aureus is responsible for a large number of infections in pediatric population; however, information about the behavior of such infections in this population is limited.', 'The increasing number of coagulase-negative staphylococci ( CNS ) causing mastitis and of bacteria resistant to conventional antibiotics has become a serious problem in recent years .', 'This result suggests a serious problem may be encountered in treatment of staphylococcal infections in Jordan .', 'Nosocomial methicillin-resistant Staphylococcus aureus ( MRSA ) infection in infants has become a serious concern and a new means of preventing the transmission of MRSA in the community needs to be considered .', 'Colonisation of cerebrospinal fluid shunts by coagulate-negative staphylococci ( Staphylococcus albus ) is a serious problem .', 'As with S. aureus , coagulase-negative staphylococci ( CNS ) represent a serious concern in hospital-acquired infections .']


Cluster  1582
['However , a drawback of ML reconstruction in particular and iterative reconstruction in general is the requirement that the reconstructed field of view ( FOV ) has to cover the whole volume that contributes to the absorption .', 'A major drawback of statistical iterative image reconstruction for emission computed tomography is its high computational cost .', 'An improvement of 16.3 % in the signal-to-noise ratio of the reconstructed image has been achieved , indicating that this method may have promising potential in future GI applications where noise is a serious problem and smaller sampling numbers are necessary .', 'The problem with 4D image denoising , compared to 2D and 3D denoising , is that the computational complexity increases exponentially .', 'In traditional coded aperture imaging ( CAI ) , the main problem with the deconvolution method is that the noise may dominate the decoding process .', 'But a major drawback of the statistical iterative image reconstruction is its high computational cost .', 'The proposed method penalizes large variations in the lifetimes and amplitudes in the spatial domain to reduces noise in the images , which is a serious problem in the conventional maximum likelihood estimation method .']


Cluster  1862
['After the DBE has completed an acquisition session for a file , TEAM can interpret and respond to end-user queries . allowing the audience to see thumbnails of every slide returned by a content-based query , regardless of whether the presenter intended for them to be seen', 'After the DBE has completed an acquisition session for a file , TEAM can interpret and respond to end-user queries . allowing the audience to see thumbnails of every slide returned by a content-based query , regardless of whether the presenter intended for them to be seen', 'After the DBE has completed an acquisition session for a file , TEAM can interpret and respond to end-user queries . allowing the audience to see thumbnails of every slide returned by a content-based query , regardless of whether the presenter intended for them to be seen']


Cluster  2033
['Cumulative trauma disorder (CTD) is a term for various injuries of the musculoskeletal and nervous systems that are caused by repetitive tasks, forceful exertions, vibrations, mechanical compression or sustained postures', 'All emergent trauma and nontrauma cavitary operations over a 5-year period (January 2010-December 2014) were prospectively enrolled.', 'Three trauma centres (75%) and 17 acute care hospitals (53%) had data for trauma patients from 2013, a total of 3535 trauma registry entries (primary admissions only), including 604 victims with an ISS > 15.', 'Admission PPS can predict mortality and poor functional outcomes in elderly trauma patients, and has potential as a trigger for delivery of PC in this vulnerable population.', 'Polytraumatized patients (aged ≥18 years, Injury Severity Score [ISS] ≥16) were included in our prospective observational study if they were admitted directly to our level I trauma center during the first hour after trauma occurred.', 'Using all admissions reported to the National Trauma Data Bank 2010-2015, we estimated risk ratios for the association between current ACS verification (vs.', 'Trauma in the elderly is a serious public health problem , with a tendency to progressive worsening with population aging .', 'Thirty-six participants with complex trauma syndrome participated in this open trial.', 'We included trauma patients admitted in two 1-year periods, before and after a major rebuilding of the trauma room.', 'The current study examined: (1) whether severity of trauma predicted treatment response, and (2) profiles of patients with regard to their responses to treatment.', 'Trauma : the burden of a preventable problem .']


Cluster  577
['Their disadvantage is that a tagged corpus is essential for training', 'Another shortcoming is that the database does not provide “true” recall', 'Sharing the metadata using the Open Archives network will contribute to increase the visibility of the AMI Corpus . sparse or impoverished training data', 'The drawback is that we only cover about half of the utterances', 'The drawback is that this context may not be sufficient', 'However , assuring error elimination by preventing difficult ( and error-permitting ) retrieval practice is a potential major drawback of the errorless approach .', 'The problem with MARD is that too much information is lost .', 'Based on the comments , the only drawback of the video annotation task is the time required to load and watch the videos', 'One serious drawback with existing subtitles is that they do not store meta-information about the speaker', 'A drawback is that the corpus is not publicly available yet']


Cluster  168
['Large between- and within-group effect sizes (d = 1.', 'This was a blinded randomized study involving 15 participants.', 'Twenty-seven nonsmoking subjects were recruited.', 'The patients were randomly assigned to an experimental (n\u200a=\u200a11) or a control group (n\u200a=\u200a11).', 'In this randomized clinical trial participants were allocated into two groups.', 'In this cohort (n = 101; mean age 10.', 'Data from 40 participants (n = 20 in each group) was available for analyses.', 'This was a 2-arm cluster randomized trial; French NHs were allocated randomly to the intervention (13 NHs) or control (13 NHs) groups.', 'This quasi-experimental study enrolled 183 students as participants, with 95 and 88 in the experimental and control groups, respectively.', 'Thirty young healthy participants were randomly divided into experimental and control group.', 'Undergraduates (N\xa0=\xa0167) enrolled in a statistics class, January-November 2015.', 'This is an unblinded study.', 'Of the 240 subjects enrolled (mean age: 22.', 'Twenty-two subjects were recruited in a prospective, randomised, masked, cross-over study.', 'Participants were randomly allocated to an experimental group (n\u200a=\u200a9) or a placebo group (n\u200a=\u200a9).', 'Randomized controlled trial including 291 participants (mean age\xa0=\xa016.', 'Subjects were randomly categorized into two groups.', 'Twenty women were randomly assigned to one of two training groups: G2X (N.', 'Participants were randomized into either the ABCD or UD arm of the study.', 'Thirty-three healthy subjects were randomly divided into three groups.', 'This was a within-subjects, randomized, and counter-balanced study.', 'Participants were randomly assigned to an experimental group (n\u200a=\u200a16) or a control group (n\u200a=\u200a16).', 'This is an observational study without a control group.', 'There were 100 participants in this study, with 50 participants in each group (RI and DL).', 'Twenty-one participants were randomized to the study (n= 11) and control groups (n= 10).', 'More participants completed tasks #1 and #2 in group B (83.', 'The sample group included 68 female university students, randomly divided into a control group (n\xa0=\xa034) and an experimental group (n\xa0=\xa034).', 'There were 906 subjects randomly assigned to the control group and 901 subjects randomly assigned to the intervention group.', 'This randomized controlled trial involved 2 interventions and a control group.', 'A total of 51 participants were randomized to the ABCD group and 50 to the UD group.']


Cluster  197
["The current study aims to evaluate the effectiveness of an 'Improving Access to Psychological Therapies' (IAPT) stepped care service model using low-intensity cognitive behavioural therapy (LI-CBT) in primary and community care settings.", 'The service meets Improving Access to Psychological Therapies (IAPT) key performance targets, and is comparable to other IAPT services using CCBT.', 'Our findings suggest individuals may value and use CBT skills if they engage with CBT as a learning opportunity at the time of treatment.', 'Combining technology with CBT is an effective way to reduce barriers to accessing mental health interventions and technology for this population.', 'Participants (n = 115) who were not receiving treatment, but had symptoms of depression, read the positive psychology or the CBT self-help book for 8 weeks.', 'To evaluate the implementation of a third sector remote CCBT @Home eTherapy service for people experiencing common mental health problems supported by individuals with lived experience.', "This study aimed to test the efficacy of 'Positive Psychology for Overcoming Depression' (Akhtar, 2012), a self-help book for depression that is based on the principles of positive psychology, in comparison with a CBT self-help book that is currently prescribed in England as part of the Reading Well books on prescription scheme.", 'To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during therapy.', 'Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression.', "The psychiatric eConsults model improved PCPs' perceptions of support for delivering mental health care and perceptions of access to specialist consultations.", 'To investigate the effectiveness of individual and group CBT for inpatients, in an interdisciplinary rehabilitation setting; the extent of psychiatric comorbidity; and who benefits the most from group CBT.']


Cluster  970
['One hundred and seventy-three mothers and 229 neonates (114 twins and 115 singletons) were included.', 'All 122 infants were available for outcome analysis.', 'Of 200 new-borns, 108 (54%) were females; 180 (90%) full term babies (37-41 weeks).', 'A total of 462 preterm and term infants (186/292) were included.', 'A total of 72 preterm infants were enrolled.', 'We included all live babies delivered in our hospital; Babies were categorised according to age, birth weight and gestational age.', 'One hundred fifty parturients were enrolled during the 36th-38th gestational weeks.']


Cluster  974
['This observational case-controlled study included twenty PwMS (median EDSS = 3, range 1.', 'Twenty-one patients (11 flat PWS, 10 hypertrophic PWS) with untreated PWS underwent 3 treatments at 2-month intervals.', 'Twenty adults with 21 PWSs on the head, trunk, and extremities were treated.', 'The findings support that the unified protocol could be an additional efficient psychological treatment for PwMS.', 'Randomized, double-blind, placebo-controlled, crossover study in a PWS Reference Center in the Netherlands.', 'Seventy adult PwMS were randomized using an internet-based computer system to either the unified protocol (n\u2009=\u200935) or treatment as usual condition.', 'Observational, cross-sectional, retrospective study with 111 patients with WPW syndrome referred for AP ablation.']


Cluster  1978
['In total, 101 patients with primary varicose veins (C2 and/or C3 stage of the CEAP classification) and 122 controls were enrolled as they appeared in our centre.', 'A prospective observational cohort study of patients presenting with symptomatic varicose veins to a tertiary referral public hospital vascular clinic between January 2011 and July 2012.', 'The purpose of this study is to examine the effect of compression therapy in patients having mechano-chemical ablation (MOCA) therapy for truncal incompetence of their varicose veins using the ClariVein® device.', 'Patients with symptomatic, uncomplicated varicose veins (CEAP class C2-C4) were examined at baseline, 1\u2009month and 1\u2009year.', 'Ninety-four patients with varicose veins underwent foam sclerothrapy alone and 88 patients with varicose veins received FSL.']


Cluster  2
['Fibrocystic changes (FCC) is the most common benign breast disease.', 'Very mild and mild fluorosis is not a serious problem for either the clinician or the patient .', 'Aggressive fibromatosis remains a serious problem with the possibility of locally aggressive behavior with high rates of recurrence .', 'The commonest type of frenum was found to be the simple type, whereas bifid frenum was not found at all.', 'Since differential diagnosis between paragonimiasis and fascioliasis can be easily done by clinical presentation and fascioliasis serology , this cross reaction is not a serious problem .', 'Endemic fluorosis is a serious problem in public health .', 'Fibrosis is also a serious cosmetic problem for patients , and in some cases it can also imply pain .', 'Fasciola hepatica infections cause huge economic losses to livestock production and are a serious problem in human and veterinary medicine .']


Cluster  1570
['Traumatic brain injury ( TBI ) is a serious public health problem in the United States , yet no treatment is currently available to improve outcome after TBI .', 'Traumatic brain injury ( TBI ) is a serious public health problem , often with devastating consequences for patients and their families .', 'Traumatic brain injury ( TBI ) is a serious public health problem as well as a leading cause of severe posttraumatic disability .', 'Traumatic brain injury is a serious public health concern since it can lead to long-term neuropsychiatric changes such as posttraumatic stress disorder and various forms of dementia .', 'One hundred twenty patients with traumatic brain injury were enrolled in this study, 89 males (74.', 'Traumatic brain injury in the United States is a serious health problem : it is a significant factor in approximately half of all trauma-related deaths , and , leads to persistent , long-term neurologic dysfunction in survivors .', 'Despite intensive research and clinical trials with numerous therapeutic treatments , traumatic brain injury ( TBI ) is a serious public health problem in the United States .', 'Traumatic brain injury ( TBI ) is a serious public health problem in the United States .', 'Traumatic brain injury is a serious public health problem in the U.S. contributing to a large portion of permanent disability .', 'Traumatic brain injury ( TBI ) is a serious problem that causes high morbidity and mortality around the world .', 'Mild traumatic brain injury ( mTBI ) is a common complication of minor head injury and a serious problem in the Iraq war returnees .', 'Traumatic brain injury ( TBI ) is a serious health concern for civilians and military populations , and blast-induced TBI ( bTBI ) has become an increasing problem for military personnel over the past 10 years .', 'Traumatic brain injury ( TBI ) is a serious public health problem .', 'Traumatic brain injury ( TBI ) , a major cause of morbidity and mortality , is a serious public health concern .', 'Traumatic brain injury ( TBI ) is a serious problem that affects millions of people in the United States alone .', 'Two-centre randomised waiting list controlled trial with 46 adults with persistent PCS after predominantly mild-to-moderate TBI (52% with post-traumatic amnesia (PTA)≤24\u2005hours), but including some with severe TBIs (20% with PTA>7\u2005days).', 'Traumatic brain injury ( TBI ) is a serious public health concern and a major cause of death and disability worldwide .', 'Traumatic brain injury ( TBI ) is a serious medical and social problem worldwide .', 'Traumatic brain injury ( TBI ) remains a serious health concern , and TBI is one of the leading causes of death and disability , especially among young adults .', 'Traumatic brain injury ( TBI ) is a serious global health problem , many individuals live with TBI-related neurological dysfunction .', 'Mild traumatic brain injury ( MTBI ) is a serious health problem that has been difficult to study because of the relative insensitivity of established anatomical imaging techniques for detecting the associated neural damage and dysfunction .', 'Traumatic brain injury ( TBI ) still remains a serious health problem and is called a " silent epidemic " .', 'In this retrospective study, 120 patients with traumatic brain injury (TBI) were recruited.']


Cluster  328
['Because of the magnitude of factors involved in the immune , genetic engineers face a serious problem of producing multitransgenic animals in the shortest possible time .', 'The problem with using SCID mice is that they have an abnormal immune system ; normally they are used at about 2 months of age , at which time they have virtually no functional T or B cells .', 'Delayed xenograft rejection remains a serious problem .', 'There is a severe shortage of human organs available for transplantation and xenotransplantation - use of animal organs has long been suggested to overcome this problem .', 'To gauge whether this constitutes a serious concern , the present study determined empirically the magnitude , persistence , and directionality of the transfer effect in wild-type C57BL/6 mice .', 'A major drawback of the current pig model is the inability to analyze antigen-specific CD8 + T-cell responses , which are critical to respiratory immunity .', 'However , mosaicism is a serious problem for genetically modified pigs .', 'A major problem with pig-to-human-tissue xenograft studies is that humans have natural antibodies to pig cells ; these antibodies would cause hyperacute rejection if pig tissues were xenografted to humans .', 'Induction of the immune response to transgene products is a serious concern in gene therapy , and is generally known to be influenced by the transgene expression profile , as well as the types of cells that express the transgene .', 'The low efficiency of transgenic animal production by microinjection has been a serious problem especially for the production of transgenic livestock .', 'The use of xenograft models has overcome the obstacle of time delay in the presentation of symptoms , which remains a crucial drawback of genetic models .', 'A significant ( though unanticipated ) problem with this model system is that it is functionally leaky : residual functional class I expression can be detected in beta 2m- mice , and small numbers of functional CD8 + lymphocytes are present in the animals .', 'Recently , occurrence of natural antibodies against Neu5Gc was shown in healthy humans and is a serious problem for clinical xenotransplantation and stem cell therapies .']


Cluster  330
['However , it can increase the chances of muscle damage , a serious problem for diabetic patients .', 'Diabetes mellitus type 2 ( T2DM ) and its vascular complications are a serious world health problem .', 'Diabetic foot is a debilitating disease arising from multifactorial process.', 'Diabetes mellitus is currently a serious public health problem worldwide , that increases the risk of presenting microvascular and macrovascular complications .', 'Peripheral vascular disease is a serious and frequent problem in diabetic patients .', 'Diabetes is a devastating global health problem and is considered a predisposing factor for lung injury progression .', 'Complications of diabetes affecting the feet represent a serious problem in China .', 'Diabetic foot disease (DFD) is more prevalent among males and is associated with an excess-risk of cardiovascular events or mortality', 'Increased susceptibility to infections is a serious problem in diabetics .', 'Foot infections commonly occur in diabetic patients , constituting a serious problem .', 'Urinary tract infection is a serious problem in diabetic patients , and asymptomatic bacteriuria ( ASB ) in these patients is a risk factor for pyelonephritis and renal dysfunction .']


Cluster  772
['Tip cryotherapy appears to be an effective therapy with minimal adverse effect for IGH.', 'IA as an add-on to targeted medical treatment for IPAH is a safe procedure with beneficial effects on hemodynamics, especially in patients with high levels of autoantibodies.', 'The objective of this prospective, open-label, single-arm, multicenter trial was to evaluate the safety and efficacy of immunoadsorption (IA) as an add-on to optimized medical treatment for patients with IPAH.', 'To evaluate the efficacy and side effects of tip cryotherapy in IGH treatment.', 'The patients showed a significant therapeutic response to immunotherapy compared to cryotherapy (P = 0.', 'The evaluation of the 10 IPAH patients (75% female; 51 ± 12 years; 166 ± 10 cm; WHO functional class III; 53% on combination therapy) revealed that IA was a safe procedure that efficiently removed IgG and autoantibodies from the circulation.']


Cluster  2271
['In conclusion , severe hypoglycaemia is a serious and not uncommon problem among elderly patients with T2DM ; it is more frequent in patients undergoing aggressive diabetes management and in users of a long-acting sulphonylurea ( eg , glibenclamide ) .', 'Hypoglycemia is a major barrier to achieving stable metabolic control in patients with diabetes which is a serious clinical concern .', 'The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients.', 'Secondary failure to oral hypoglycemic agents ( OHAs ) is a possible outcome for non-insulin-dependent diabetes mellitus ( NIDDM ) patients and poses a serious therapeutic problem .', 'Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.', 'Hyperglycemia is a serious health problem prevailing in diabetes patients .', 'Hypoglycemic coma is a serious and not an uncommon problem among elderly patients with diabetes mellitus and treated with insulin and/or oral hypoglycemic drugs .', 'Hyperglycemia is a serious health problem in government employee .']


Cluster  925
['Sucralfate gel does not improve healing of PU compared with placebo.', 'A prospective, observational study to evaluate adherence of Suprathel<sup>®</sup> to the wound bed, reepithelialization time, grafting, wound colonization and infection, pain, dressing changes, length of hospital stay (LOS) and scar formation.', 'Ninety-two patients with venous ulcers were randomized to receive ozone gas bath combined with EVLT (OEVLT group) or EVLT alone (EVLT group).', 'PPI\xa0+\xa0rebamipide was more effective in reducing the ulcer residual ratio after ESD.', 'Evaluation of usability and effectiveness of Suprathel<sup>®</sup> in the treatment of partial thickness burns in children.', 'Compared to conventional therapy, a highly significant improvement in the ulcer size was observed post-PRP therapy (P-value = .', 'with a regimen of regular repositioning of patients and a good diet, the APAM was effective in preventing pressure ulceration in the 100 patients who were at a high or very high risk of skin breakdown and pressure ulceration.', 'Forty hospitalized patients with stage II PU were included in this prospective, double-blind, randomized, placebo-controlled trial and were randomly divided into 2 groups receiving either sucralfate gel or placebo, on a daily basis.', 'The results of the pressure ulcer prevalence study in rehabilitation departments where Axtair Automorpho® Plus supports were available as well as results of the study of pressure ulcer incidence in patients bedridden on Axtair Automorpho® Plus, confirm the expected benefit provided to patients in terms of prevention.']


Cluster  1042
['In a prospective observational study, parturients were asked to rate their pain intensity on a visual analog scale and numerical rating scale, before and 30min after initiation of epidural analgesia.', 'Pain, both from the surgical site, and from other sources such as musculoskeletal backache, can persist after caesarean section.', 'Labour induction and elevated numerical rating score for pain are predictive of poor recovery after childbirth.', 'Persistent pain from a variety of sources after caesarean section is common.', 'The agreement between calculated percentage pain reduction from a visual analog or numerical rating scale and patient-reported percentage pain reduction in the context of labor epidural analgesia was moderate.']


Cluster  54
["Many Litchi chinensis cv . Baitangying orchards are suffering from a serious fruit cracking problem , but few studies have improved our understanding of the mechanism or the molecular basis of cracking susceptibility in ' Baitangying ' .", 'Browning reactions in fruits and vegetables are recognized as a serious problem for the European food industry , particularly for the mushroom sector .', 'The severe deficiency of iron or ferric chlorosis is a serious problem of most citrus trees established in calcareous soils , as a result of the low availability of iron in these soils and the poor uptake and limited transport of this nutrient in trees .', "Fruit cracking is a serious problem in Litchi chinensis cv . Baitangying orchards , but few advances have been made in understanding the molecular basis of cracking susceptibility in ' Baitangying ' .", "The genetic disorder known as ' crumbly ' fruit is becoming a serious problem in the European raspberry industry .", 'Practical Application : Pericarp browning is a serious problem to storage and transport of harvested rambutan fruit .', 'Disease during storage caused by microbial infection is a serious problem of jujube fruits .', 'Apple replant disease ( ARD ) is a severe problem in apple production worldwide .', 'Abnormal fruitlet abscission is a serious problem in the production of litchi ( Litchi chinensis ) , an economically important fruit widely grown in South Asia .', 'In recent years , kiwifruit rot has been a serious problem in Sichuan Province , one of the important kiwifruit production areas of China .', 'During preservation , Jerusalem artichoke ( JA ) tubers are subjected to deterioration by mold fungi under storage , which signifies a serious problem .', 'Apple Valsa canker ( AVC ) , caused by Valsa mali , results in a serious and persistent disease problem for apple production in China and is difficult to control by chemical and agricultural measures .']


Cluster  1774
['The results suggest that the fundamental movement skill performance of children with severe ID can be improved, although the significant effects may only be evident after long (1\u2009year), rather than short-term (6 months), time periods.', 'An explorative RCT was conducted among boys with DMD with impaired arm function (n = 16).', 'Adolescents with Developmental Coordination Disorder (DCD) usually experience psychomotor difficulties that affect their participation in everyday tasks and sports.', 'This study investigated the effect of gravity-compensated 3D-training for the arms on the functional abilities in boys with DMD.', 'The purpose of this study was to examine the effect of a one-year physical activity intervention on FMS among boys with severe ID.', 'Movement disorders appear early , leading to severe patient and family distress , and pose a serious management dilemma because of a paucity of clinical trials assessing treatments in the pediatric population .']


Cluster  1758
['We divide key/response entity pairs into four categories : existence of nonadaptive sentences that may be inappropriate in some of the scenes', 'In the final case , a fragment of a narrative sentence consisting of ten words was detected as a single OOV word . the metrics they use for evaluation compare to human references , but they do not necessarily reflect human acceptability or grammaticality', 'We divide key/response entity pairs into four categories : existence of nonadaptive sentences that may be inappropriate in some of the scenes', 'We divide key/response entity pairs into four categories : existence of nonadaptive sentences that may be inappropriate in some of the scenes', 'The other problem is existence of nonadaptive sentences that may be inappropriate in some of the scenes']


Cluster  2177
['Although there generally is ready access to appropriate care and short transport times , burn injury remains a serious concern .', 'Introduction Burns are a serious public health problem globally , causing an estimated 265,000 deaths per year .', 'Injuries and deaths from burns are a serious , yet preventable health problem globally .', 'Burn injuries are a serious problem worldwide , with most occurrences in low- and middle-income countries .', 'Burn injuries are a serious public health problem .', 'The program has the potential to support parents of children with burns.', 'Burn injuries are a serious global public health concern with significant worldwide mortality and morbidity rates .', 'Burns are a devastating public health problem that result in 10 million disability-adjusted life-years lost in low- and middle-income countries .', 'Sandal burn injuries are a serious health problem .', 'Occupational burns have been determined to be a serious public health concern .', 'As a serious yet preventable problem , scald injuries in children have been a priority for prevention in Australia and other developed countries .', 'Consequently we can conclude that in Lithuania as well as all over the world burns are considered to be a serious medical , psychological , economic and social problem .']


Cluster  1439
['From July 2012 to February 2015, 50 patients identified with ESRD, with CLI, treated with DEB angioplasty.', 'In elderly patients, ESD is an acceptable treatment for EGC in terms of both short- and long-term outcomes.', 'In 1996, we studied 128 patients with ESRD undergoing HD; 47 subjects (36.', 'We enrolled 174 patients (91 males, 83 females; mean age 69±13years) with ESUS.', 'We enrolled 30 asymptomatic ESRD patients on maintenance HD.', 'This was a single-center randomized controlled trial of 101 patients undergoing ESD.', 'DEB is effective in the treatment of below the knee critical stenosis and occlusions in ESRD patients with critical limb ischemia.']


Cluster  1542
['Respiratory tract infections ( RTIs ) represent a serious problem because they are one of the most common cause of human death by infection .', 'Infections of the lower airways pose a serious problem for the health service , both because of the burden of the disease and because of the large number of resources that need to be devoted to treating it .', 'Respiratory infections caused by viruses such as influenza and coronavirus are a serious global problem due to their high infection rates and potential to spark pandemics , such as the current COVID-19 pandemic .', 'Respiratory illness in children with disability : a serious problem ?', 'Recurrent respiratory tract infections ( RRTIs ) in children constitute a serious problem worldwide .', 'Considering the fact that respiratory prolongs patients life but does not cure , there is a serious problem for patients , their families , the nursing staff and-more and more doctors .', 'Lower respiratory tract infections in the intubated patient constitute a serious health problem due to their associated morbidity and mortality .', 'Respiratory dysfunction is often a serious problem in these patients before TAE .', 'Respiratory tract infections still represent a serious medical problem , mainly in people with different dysfunctions of the immune system .', 'Diseases of respiratory organs constitute a serious socio-medical problem in this country due to high morbidity , mortality , and disability rates .', 'Infectious respiratory diseases are a serious health concern worldwide .']


Cluster  691
['A drawback of learning by using complex functions is that complex functions do not generalize well and thus tend to over-fit', 'At least in the second case , weighted coefficients are almost unavoidable . any data it is trained on must be in-coverage of the parser', 'Figure 2 gives baseline alignments and combined alignments on two sentence pairs in the training data . complex functions do not generalize well and thus tend to over-fit', 'At least in the second case , weighted coefficients are almost unavoidable . any data it is trained on must be in-coverage of the parser']


Cluster  232
['Increase in concentrations of various greenhouse gases and their possible contributions to the global warming are becoming a serious concern .', 'With climate modeling predicting a raise of at least 2 ° C by year 2100 , the fate of ice has become a serious concern , but we still do not understand how ice grows ( or melts ) .', 'Global warming caused by the increasing CO2 concentration in atmosphere is a serious problem in the international political , economic , scientific and environmental fields in recent years .', 'Climate change is a serious global problem , and the majority of greenhouse gas emissions come from industries that are enabled by engineers and represented by the engineering professional institutions .', 'As much as energy supply remains a major challenge in most of the African countries , the compounding environmental effect of energy consumption has continued to be a serious concern to policymakers and environmental stakeholders .', 'Even relatively conservative assumptions put a severe upward pressure on forecast global energy demand and highlight three areas of concern .', 'Global climate change is a vexing economic , environmental , and public health problem .', 'Accumulation of greenhouse gases especially CO2 in the atmosphere leading to global warming with undesirable climate changes has been a serious global concern .', 'Ice formation is a catastrophic problem affecting our daily life in a number of ways .', "Global warming and climate change have become a serious environmental problem and China 's carbon emissions are currently the highest in the world .", 'City-scale warming is becoming a serious problem in terms of human health .', 'Global warming is a serious problem facing the world today .']


Cluster  973
['A total of 927 long-term care residents who had SE measurements and did not have a serious communication problem .', 'A convenient sample of general practitioners in North Yorkshire invited care homes with nursing, to participate in the study.', 'In this real-life study of all patients admitted to a Geriatric Post Emergency Unit, 83% of the patients had a treatment modification during hospital stay.', 'Disruptive vocalizations ( DVs ) constitute a serious problem in geriatric nursing homes .', 'LOSS OF FUNCTIONAL INDEPENDENCE : This is a serious problem in the management of older subjects .', 'Within the framework of focus groups the technical system was adapted for elderly users.', 'Thirty-two community-dwelling adults, 65 to 85 years old, were referred to 2 different community pools for APT.', 'PrUs were a serious problem in this community-dwelling economically vulnerable group , and home care played a critical role in providing health care to this population .', 'A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted.', 'Amid the rapid ongoing shift from treating the elderly in hospitals to treating them at home , self-care by elderly people living alone is a serious and complicated problem .', 'To explore the recognition and assessment of resident deterioration in the nursing home setting.', 'Twenty-five older adults and 11 family members living with advancing chronic illness received bi-weekly home visits by a nurse navigator over a 2-year period.', 'Hospital-associated deconditioning due to a combination of illness and inactivity is a serious problem for elderly adults .', 'In line with previous findings, our study found high levels of functional dependence among institutionalized elders.', 'The objective of this study was to evaluate the reality of such assessment and optimization in real life (usual care) in a population of elderly individuals admitted to a geriatric unit.']


Cluster  897
['The JHEPM probability is a predictive parameter that can be used to decide a follow-up treatment strategy for ALI patients.', 'HBOT plus existing conventional treatment was associated with a better outcome than conventional treatment alone.', 'For MP, mean aggregation was decreased for COL and AA with combination therapy and for ADP with all treatments.', 'The aim of the study was to show whether the hydroxychloroquine-azithromycin (HCQ-AZM) combination prolonged Tpeak-to-end (TpTe) duration and TpTe/QT interval ratio or not.', 'Non-inferiority of combination therapy in comparison to standard therapy alone could be demonstrated.', 'HCQ-AZM combination increased TpTe duration.', "A Markov model was developed to assess the impact of ivabradine on mean survival and quality of life over a patient's lifetime (10 years).", 'The primary objective of the study is to demonstrate the non-inferiority of UST monotherapy compared to MTX/UST combination therapy as measured by mean DAS28 values at week\xa024.', 'The addition of rhTM to conventional treatment improved overall survival in patients with AE-IPF.']


Cluster  740
['Nor had any symbols been evaluated for transparency or cultural sensitivity by local AAC users , their supporting professionals and families . it does not guarantee that the output parse is a projective dependency tree , only a projective dependency forest , that is , a sequence of adjacent , non-overlapping projective trees ( Nivre 2008 )', 'Nor had any symbols been evaluated for transparency or cultural sensitivity by local AAC users , their supporting professionals and families . it does not guarantee that the output parse is a projective dependency tree , only a projective dependency forest , that is , a sequence of adjacent , non-overlapping projective trees ( Nivre 2008 )', 'For instance , the top parse for the sentence : Cars and pick-up trucks with badly twisted and still smouldering frames littered the three compounds , which housed villas and four-storey blocks . the use of EUROVOC , which is a specific resource workable only for European languages', 'For instance , the top parse for the sentence : Cars and pick-up trucks with badly twisted and still smouldering frames littered the three compounds , which housed villas and four-storey blocks . the use of EUROVOC , which is a specific resource workable only for European languages']


Cluster  1383
['In a national survey , seriously ill Medicare beneficiaries described financial hardships resulting from their illness-despite high beneficiary satisfaction with Medicare overall and the fact that many have supplemental insurance . About half reported a serious problem paying medical bills , with prescription drugs proving most onerous .', 'The increase in medical expenditure has been worsening and poses a serious social problem .', "Many of our nation 's children have little or no access to health care , a serious problem that threatens their health and well being . If we are to provide adequate , cost-effective , and accessible health care , fundamental reform of the nation 's health care system must be undertaken .", 'Health Plans . The only game in town ? Physicians across the country say that health plan consolidation is becoming a serious problem -- and Washington needs to step in and do something about it .', 'Data show lack of insurance a serious problem .', 'However , data on the medical expenses of all inpatients in 2014 at a public Tier-three hospital suggests that supply-induced demand ( SID ) is a serious concern and that , under the design of the current schemes , a higher benefit level has a greater impact on the total expenses of insured patients .', 'Healthcare spending is concentrated, with a minority of the population accounting for the majority of healthcare costs', "Seventy-three percent of U.S. physicians reported that patients ' inability to afford necessary treatment was a serious problem , as compared with 25 percent in Canada and 15 percent in West Germany .", 'After three years experience , the authors try to answer some important questions about community financing : To what extent does payment of fees have an influence on the use of health services ? How are the funds collected and used and is embezzlement a serious problem ?', 'It has also been considered a serious social problem that increases the use and costs of health services .', 'Moreover , with growing mobility and rising expectations of medical coverage around the world , the fragmenting of safety nets by the political honeycomb of statehood will become a vexing problem in coming decades .', '  This link between health insurance and access to health care makes the increasing number of uninsured children a serious problem not only for children , but for society as a whole .', 'This is one of a number of programmatic studies on the allocation of scarce medical resources', 'The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem .', 'In recent years the growth of Medicaid spending has been a serious state budgetary problem .', "Many people , particularly the business leaders and legislators who must find ways to pay most of the nation 's health care bill , consider current and projected rates of health expenditure growth a serious problem .", 'Due to the general aging of society , increasing national medical expenditures are becoming a serious problem .']


Cluster  222
['These dozens of generalized semantic tags help to address the issue of feature sparseness', 'has the empty set as denotation , if each disjunct is invalid . it is necessary to re-classify many words if the application domain changes significantly', 'Table 4 shows example noun clusters created using Q = 0.15 . the restriction to pairwise predicates', 'Because such a semantics can be automically induced , it escapes the limitation of depending on relations from hand-built training data , knowledge bases or ontologies', 'Sections 5 and 6 report experiments and results . frequently two semantically similar senses are distant in the WordNet hierarchy', 'The same method can be used repeatedly to create connections to multiple language WordNets . the time complexity of inference as presented here is quadratic in the number of classes rather than linear', 'hypothesis that for this type of semantic space the multiplicative vector combination function produces representations which have a sounder probabilistic basis . it can only handle approximately 20 words or phrases', 'In fact , it was this availability of the generalization operation that suggested a simplified account of coordination facts in English now being used in GPSG -LSB- 15 -RSB- and in an extension of PATR-II -LSB- 81 . training time is increased because of the extra nested loop needed to calculate feature covariances', 'In more detail , we first gathered lexical translation probabilities of the form P -LRB- s | t -RRB- by running five iterations of Model 1 on the training corpus . a cluster may correspond to a sense that is not shared by the original source word used to generate the translation set', 'In more detail , we first gathered lexical translation probabilities of the form P -LRB- s | t -RRB- by running five iterations of Model 1 on the training corpus . a cluster may correspond to a sense that is not shared by the original source word used to generate the translation set', 'This is a naive but reliable way to capture lexical semantic preferences without a lot of effort . the scheme will be less general', 'The MWER templates are instantiated at each position of the input sequence . their method limits the training of multi-sense embeddings to the M most common words , forcing a complete re-training of the model should a new word of interest appear', 'hypothesis that for this type of semantic space the multiplicative vector combination function produces representations which have a sounder probabilistic basis . it can only handle approximately 20 words or phrases', 'However , its limitation is that the distance measure does not capture sufficient information of semantic relations between language constituents', 'In addition to WordNet hypernyms , we also cluster verbs , nouns and adjectives using the dependencybased word similarity of -LRB- Lin , 1998 -RRB- and treat cluster membership as types . the solution may be only a local optimum', "Lexical items with similar characterics can be grouped together as a class ; we may , for example , have a class ` noun ' as a superclass of lexical items ` boy ' , ` girl ' , ` computer ' and so forth . measure word generation in a general SMT system", 'And second : is it possible to extract from the kind of inference rules automatically derived in machine learning approach , information that can be used to specify this metagrammar ? the distance measure does not capture sufficient information of semantic relations between language constituents', 'The P function enables us to utilize incomplete succeeding contexts to approximately predict words . this reduces the efficiency of the dynamic programming']


Cluster  755
['O-glycan deficiency and the associated incapacity to extend serum half-life is a major drawback of the boCTP .', 'The results indicate a serious problem in the use of some assays that were designed to evaluate residues bulk tank milk samples to analyze samples from individual cows .', 'The proportion of such " bead binders " in different serum panels frequently exceeds 5 % and is therefore a severe problem .', 'However , a major drawback of mammalian WEC is that the culture media currently in use display batch variations and are undefined , as they contain serum or serum replacements of unknown composition .', 'However , continence is not perfect , and fecal soilage is a troublesome problem for a small number of patients .', 'One limitation with these animal models is that the foods have to be given in powdered form and not in the physical form in which they are consumed by humans .', 'A problem with this approach is that animals with long gut transit times , such as the horse , may find it difficult to associate a chosen food with its nutritional consequence when alternative foods are presented simultaneously .', 'A major drawback of particle titration methods is the lack of consistent correlation between the resultant titer and the infectious titer .', 'However , a methodological problem with analyzing stool samples is that samples are treated and stored differently prior to submission for analysis potentially influencing the composition of the microbiota and its metabolites .']


Cluster  487
['Acute myocardial infarction ( AMI ) is a serious health problem that must be identified in its early stages .', 'Myocardial infarction ( MI ) is known as a serious global problem , which has a high mortality rate and cause severe heart damage .', 'Acute mesenteric ischemia is highly lethal and therefore a serious problem for surgery and intensive care medicine ; accordingly its pathophysiology warrants further study .', 'Cardiac arrest due to ischaemia is frequently the first manifestation of cardiovascular disease.', 'Percutaneous coronary intervention can be a safe and feasible method of revascularisation in ischaemic HF.', 'Current medical treatments of myocardial infarction ( MI ) face a serious shortcoming in that they can not reverse the detrimental effects of ischemia induced necrosis .', 'Ischemia is a serious problem in clinical medicine , and effective methods are needed to detect ischemia before the injury becomes irreversible .', 'Acute myocardial infarction ( AMI ) is a fatal manifestation of ischemic heart disease and remains a major public health concern worldwide despite advances in its diagnosis and management .']


Cluster  1797
['A major drawback of conventional descriptive profile ( CDP ) in sensory evaluation is the long time spent in panel training .', 'Fifty healthy adults divided into five age groups were tested during the three test protocols for CDP: sensory organization test (SOT), motor control test (MCT), and adaptation test (ADT).', 'Some but not all CDP outcomes with a virtual visual environment were comparable to published norms.', 'To obtain normative values in healthy adults age 20-69 for a CDP system that uses a full-field dynamic visual surround.']


Cluster  69
['Although the cellulose microfibril organization in guard cell (GC) walls play a crucial role in the mechanism of the stomatal function, recent work showed that matrix cell wall materials are also involved', 'UWF AF changes in STGD1 are not limited to the posterior pole and may extend more peripherally.', 'A main problem with cell nuclei images is that the intensity structure of different nuclei differs very much ; thus , an intensity-based registration scheme can not be used directly .', 'The pathogenesis of basilar invagination in group B is related to atlantoaxial instability.', 'However , one major problem with this method is that labeling of cell bodies is obscured by high levels of staining in synaptic boutons , particularly within forebrain structures where this staining is most intense .', 'The hyper-acetylated cells encountered a serious microtubule (MT)-kinetochore attachment problem , although the kinetochores are intact at ultrastructural level .', 'The main problem with stained paraffin sections was that most small neurons had multiple nucleoli attached to the membrane of the nuclei , which only measured 10 microns in diameter .']


Cluster  2317
['Teacher burnout is regarded as a serious problem in school settings .', 'Employee burnout is perceived to be a serious problem in human service organizations serving persons with severe mental illness .', 'Presenteeism is a serious emerging problem in an occupational setting .', 'Awareness is growing that worker burnout is a serious problem in the child welfare field .', 'Despite the implementation of working hour restrictions in the U.S. in 2013 , the high rate of burnout remains a serious problem .', 'One may conclude that employee withdrawal , whether in the form of avoidable turnover or unscheduled absenteeism , represents a serious managerial problem for many institutions .']


Cluster  65
['Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies .', 'Patient misidentification in imaging examinations has become a serious problem in clinical settings .', 'The problem with this practice is that sensitive information about patients and care providers may be disclosed in the process .', 'In the planning of interventional treatment and surgical procedures , false recognition , as in the unique case in the present report , is a serious problem .', "This phenomenon is a serious problem in medicine as it affects interpersonal relationships between medical professionals and patients , patients ' well-being , and the capability of following medical recommendations .", 'To know or not to know : a perilous conundrum for health care providers .', 'Breaching confidential health information is a serious ethical problem and a communication issue that , historically , has received limited empirical , theoretical , or practical attention .', 'Seventy-six 3rd-year medical students participated in an 8-station OSCE and were randomized to either a control group or to 1 of 2 experimental conditions simulating test security breaches: station topic (i.e., providing a list of station topics prior to the examination) or egregious security breach (i.e., providing detailed content information prior to the examination).', 'What can the clinician trust -- research ? Theory ? Clinical knowledge ? : introduction to a serious problem and preview of some solutions .', 'A significant number of the surveyed physicians have demonstrated a serious lack of knowledge of the nature , dangers and management of an extremely common health problem .']


Cluster  1209
['Currently , the World Health Organization warns that the rapid spread of the virus Zika in both Americas and an increase in the number of children born with microcephaly in these regions begins to be a serious epidemiological problem .', 'Currently , the World Health Organization warns that the rapid spread of the virus Zika in both Americas and an increase in the number of children born with microcephaly in these regions begins to be a serious epidemiological problem .', 'Zika virus ( ZIKV ) infection is a serious public health concern due to its ability to induce neurological defects and its potential for rapid transmission at a global scale .', 'Zika has developed into a serious global health problem because , while most cases are asymptomatic or very light , babies born to Zika - infected mothers may develop microcephaly and other very serious birth defects .']


Cluster  2112
['The aim of this study was to determine whether transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) increase the effectiveness of neck stabilization exercises (NSEs) on pain, disability, mood and quality of life for chronic neck pain (CNP).', 'Twenty subjects with neck pain were randomly allocated to the SMI and CCFE groups (n= 10 each).', 'Neck is one of the most common sites of musculoskeletal symptoms, and muscle shortening and weakness is observed to be a common cause of neck pain and disability.', 'Increased deep flexor endurance and decreased EMG activity of SCM, AS and SC muscles suggest an important role for stabilizing exercises on reducing the activity of superficial muscles in chronic neck pain.', 'To investigate the effects of different exercise treatments on neck muscles in patients with chronic neck pain.', 'To evaluate the effects of CT, with or without the addition of NM, on pain, function, and disability in patients with CR.', 'One hundred and twenty four patients with neck pain of CS were included, and then they were randomly divided into a PNMES group and a control group in a ratio of 1:1.', 'To compare the effects of stabilization and routine exercises on chronic neck pain.', 'Axial neck pain can frequently be a vexing clinical problem for practitioners .', 'Patients with chronic non-specific neck pain were randomly assigned to cupping massage or a wait list control.', 'These results suggest that the NMCT can pain relief, recovery from neck disability, ROM, and deep flexor endurance for patients with CR.', 'The results of this study demonstrated that PNMES is more effective than Sham PNMES for neck pain relief in patients with CS.']


Cluster  1394
['The ingestion of caustic substances represents a serious problem , often with devastating consequences on the esophagus and the stomach .', 'Caustic ingestion is a serious medical problem with a variety of clinical presentations and a complicated clinical course .', 'Caustic ingestion is a serious medical problem affecting anywhere from 5,000 to 15,000 persons per year .', 'Caustic esophagitis is a serious clinical problem and many agents are currently tried out in many experimental models .', 'Oesophageal strictures developing after caustic ingestion in children are a serious problem , and several protocols to prevent stricture formation have been proposed .', "Caustic stenosis is a serious problem in children due to its complicated resolution and implications in important areas like nutrition , as well as the child 's tolerance to the measures taken to correct them ."]


Cluster  1192
['The aim of our study is to validate the efficacy and safety of autologous plasma filler in treating nasolabial fold wrinkles.', 'A total of 20 subjects with different types of facial wrinkles were included in this study.', "The clinical improvement with sufficient patients' satisfaction and no significant adverse events demonstrated that novel autologous plasma filler could be considered as efficient and safety treatment option for nasolabial fold wrinkles.", 'One hundred seventy subjects with bilateral nasolabial folds rated as moderate or severe, according to the Wrinkle Severity Rating Scale (WSRS), received injections of HARRL in the nasolabial folds on one side of the face and HAJU on the other side.', 'To compare the effectiveness and safety of 2 hyaluronic acid fillers (HAEC and HARES) for treatment of moderate nasolabial folds (NLFs).', 'To compare the effectiveness and safety of two HA fillers (HAED and HAPER) for the treatment of severe nasolabial folds (NLFs).', 'This study aimed to evaluate clinical efficacy of nitrogen plasma for the treatment of mild-to-moderate periorbital wrinkles.', 'This study was performed to compare the preclinical characteristics, clinical efficacy, and safety of a new HA filler, IDHF-001, with Restylane SubQ in the treatment of nasolabial folds (NLFs).']


Cluster  1366
['Arsenicosis became a serious problem for the affected communities .', 'The neurotoxicity of arsenic is a serious health problem , especially for children .', 'Chronic arsenic toxicity is a serious environmental health problem across the world .', 'Loss of cognitive function due to arsenic exposure is a serious health concern in many parts of the world , including China .', 'The environmental contaminant arsenic causes cancer , developmental retardation , and other degenerative diseases and , thus , is a serious health concern worldwide .', 'Arsenic in drinking water presents a serious public health problem in Serbia , but its relationship with diabetes has not been studied previously .', 'Diabetes is a menacing problem , particularly to inhabitants of groundwater arsenic contaminated areas needing new medical approaches .', 'The high toxicity of arsenic derivatives converts this element in a serious problem of public health worldwide .', 'Arsenic poisoning continues to be a serious medical problem that may easily be overlooked or misdiagnosed .', 'The present data suggested that exposure to arsenic is associated with an increased prevalence of underweight , a serious health problem in developing countries , which in turn is associated with increased skin manifestation of arsenic poisoning .']


Cluster  2259
['B coagulans LBSC was safe for human consumption and efficacious in alleviating overall pathophysiological symptoms of IBS and thereby improving inclusive quality of life evaluated.', 'This randomized, double-blind, placebo-controlled, phase II dose-finding exploratory trial included 409 female outpatients with IBS-D treated in Japan.', 'A retrospective observational study of 100 newly diagnosed patients with IBD was performed.', 'Recently, the Inflammatory Bowel Disease-Disability Index (IBD-DI) was developed to assess disability in inflammatory bowel disease (IBD).', 'Twenty HC and 20 IBS patients were included.', 'After translation into Portuguese, the IBD-DI was administered by two interviewers to IBD patients at baseline and after 4 weeks and 4 months.', 'To compare the rates of clinical remission and the rates of adverse events in IBD patients treated with either standard treatment with azathioprine or low-dose azathioprine in combination with allopurinol.', "A total of 118 IBD patients (86 Crohn's disease [CD] and 32 ulcerative colitis [UC]) and 23 healthy controls (HC) were prospectively enrolled.", 'Three hundred and nine individuals with IBS were randomly assigned to either the full treatment protocol (experimental condition) or the same treatment protocol without systematic exposure (control).', 'Recent evidence indicates that new approach of the diet with low fermentable oligo-di-mono-saccharides and polyols (FODMAPs) may have an effective role in management of the patients with irritable bowel syndrome (IBS).', 'Dysbiosis is associated with various systemic disorders including irritable bowel syndrome (IBS).', 'A major drawback of oral treatment of inflammatory bowel disease ( IBD ) is the non-specific distribution of drugs during long-term treatment .', 'We now know that significant numbers of patients with SpA have associated clinical IBD and almost half of them show subclinical gut inflammation , yet the connection between the gut and the musculoskeletal system has remained a vexing problem .', 'To determine patient preferences regarding IBD treatment objectives, specially the attributes they value most and the symptoms to be controlled as a priority.', 'Currently , inflammatory bowel disease ( IBD ) is a serious public health problem on the rise worldwide .']


Cluster  304
['These results indicated that clenbuterol induced the muscular hypertrophy but inhibited the longitudinal growth of bones in young male rats , which may be a serious concern in any ergogenic use .', 'In patients, cholesterol-synthesis markers were significantly higher comparing to CG.', 'Another area of development is that of acyl coenzyme A cholesterol acyltransferase inhibitors , i.e. , drugs interfering with cholesterol esterification in tissues , particularly in the arterial wall ; the major problem with these seems to be that of poor tolerability and of lack of definitive proof of plasma cholesterol reduction in humans .', 'Fifty-five patients with familial hypercholesterolaemia who had discontinued statins due to muscle symptoms.', 'MP is a viable option for lipid-lowering therapy in statin-intolerant patients with hypercholesterolaemia, with good efficacy and safety profiles.', 'In this first study to evaluate the impact of statins on coronary inflammation, we observed that the anti-inflammatory impact of statins is substantially greater within coronary plaques that contain HRM features.', 'Statin adherence is a serious problem in patients with hyperlipidemia .', 'Despite the obvious heterogeneity and a certain paucity of studies , we found consistent results concerning the prevalence of hypercholesterolemia in Portugal , and we can state that this constitutes a serious health problem in our country .', 'Despite the obvious heterogeneity and a certain paucity of studies , we found consistent results concerning the prevalence of hypercholesterolemia in Portugal , and we can state that this constitutes a serious health problem in our country .']


Cluster  1431
['This observational, cross-sectional study involved 42 dissected adult knees.', 'Extensive surgical excision of knee VMs is a safe procedure with good outcomes in terms of pain, function, and quality of life.', 'The management of patellae with a severe bony deficiency during revision total knee arthroplasty is a challenging problem .', 'Severe stiffness after total knee arthroplasty is a debilitating problem .', 'Trigger points (TrPs) in the lower-limb are under-investigated and may be a contributory factor in knee pathologies.', 'Chronic disruption of the extensor mechanism is a devastating problem after total knee arthroplasty .', 'Further investigation is needed to understand the relationship between TrPs around the knee and knee pathologies, particularly in females.', 'Forty-one knees in 39 patients had patellofemoral joint replacement using the Zimmer Gender-Solutions patellofemoral prosthesis.', 'Forty knees in 38 patients were available for one-year follow-up.', 'At a minimum of 24months of follow-up, graft tensioning using the self-balance technique yielded similar patellar stability and knee function compared with the arthroscopy-view procedure in the MPFL reconstruction.', 'A prospective study was conducted from September 2016 to March 2017 in a total of 120 patients undergoing unilateral total knee arthroplasty.', 'Despite improvement in pain and perceived function in older adults following total knee arthroplasty (TKA), objective outcome measures of muscular impairment and ambulatory function demonstrate significant deficits.']


Cluster  720
['For infants with a postmenstrual age of greater than 32 weeks who are ready to initiate oral feeding, postponing oral bottle feeding for 1 week may be considered as an intervention to reduce physiological distress.', 'To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants.', 'The aim of this study was to determine the effect of a 1-week delay in the initiation of oral feeding on feeding performance, transition time, weight gain, and cardiorespiratory responses in preterm infants.', 'It was determined that a pacifier given before feeding is effective on regulating physiological parameters and supporting feeding performance in preterm infants.', 'Pacifier use improved the sucking skills and shortened the time to transition to full breastfeeding and to discharge in preterm infants receiving complementary feeding.', 'Interventions to address suboptimal breastfeeding in primiparous women should consider the pervasiveness of early milk expression and in-hospital formula supplementation in this population, as well as the trajectory of common problems.', "EFS-trained interprofessional clinicians in 3 settings scored 142 feeding observations of infants 33 to 50 weeks' postmenstrual age.", "This pilot study evaluates the effectiveness of nonnutritive sucking at the mother's breast in premature infants to facilitate breastfeeding performance and exclusive breastfeeding.", 'A randomized controlled experimental design was used to determine the effect of a pacifier given before feeding on physiological characteristics and feeding performance in preterm infants initially fed orally.', "Infants ≤ 1000 g birthweight were randomised to one of four arms, either low (4 ml/kg/day) or high (24 ml/kg/day) initiation and either slow (24 ml/kg/day) or rapid (36 ml/kg/day) advancement of exclusive feeds of human milk (mother's or donor) until a weight of 1200 g was reached.", "Early initiation of nonnutritive sucking at the mother's breast in very preterm infants is a safe and effective intervention to facilitate maturation of oral feeding and breastfeeding behavior."]


Cluster  989
['Rotaviruses ( RV ) is a serious public health problem in developing and developed countries .', 'To determine the presence of gastrointestinal pathogens in children under five years of age with diarrhea in a Chilean rotavirus surveillance center.', 'Congenital rubella remains a serious health problem in Italy and a successful vaccination strategy is required .', 'Rubella in a practicing obstetrician : a preventable problem .', 'Rotavirus vaccines have the potential to significantly reduce a serious public health problem in the United States .']


Cluster  180
['There was a large variability in swaddling positioning of both arms and legs.', 'To observe the corrective effects of maternal extreme flexure and hip abduction combined with contralateral side-lying on persistent foetal occipito-posterior position.', 'Maternal extreme flexure and hip abduction combined with contralateral side-lying has better correction effect on persistent foetal occipito-posterior position.', 'A drawback of this approach is that the child is still awakened by wet sheets .', 'Across 2 pediatric hospitals, the swaddling positioning of each open-crib infant in the newborn nursery and neonatal intensive care unit was examined.']


Cluster  1904
['One problem with empirically answering this question is that physical proximity is typically confounded with other factors , such as informational directness , shared group membership , or increased efficaciousness .', 'The aim of this study was to evaluate the effectiveness of the mobile cooperation intervention in improving the competence and self-efficacy of students and the quality of the clinical learning environment.', 'Sociodemographic subgroup differences in multiple mini-interview (MMI) performance have been extensively studied within the MMI research literature, but heterogeneous findings demand a closer look at how specific aspects of MMI design (such as station type) affect these differences', 'Encounters could be caring, uncaring, and carried out using a person-centered approach.', 'We demonstrate that a time-efficient intervention increased perceptions of in-person communication and the number of teaching interactions between interns and fellows.']


Cluster  2144
['In this condition , recurrent febrile urinary tract infection can be a serious problem , and can easily cause renal damage due to relatively short ureters and high pressure in the kidney .', 'Septicemia is a serious problem in hemodialysis patients because it can lead to life-threatening complications and a persistently elevated risk of death .', 'Microbial contamination of dialysis fluid is a serious problem in therapy .', 'Although neutropenia is manageable in most situations , it remains a serious problem that , at its worst , can progress to life-threatening septicemia .', 'Fungal infections are a serious problem among haemodialysis patients .']


Cluster  152
['Emergence of resistant mutations in drug targets represents a serious problem in the targeted chemotherapy .', 'A major drawback of lamivudine treatment is the development of resistance , observed in 15 - 20 % of patients after 1 year and up to 70 % after 5 years of continued treatment .', 'Despite its success , development of resistance mechanisms is still a serious clinical problem .', 'Nevertheless , acquired resistance to RTK inhibitors ( RTKi ) remains a serious problem .', 'Since convergence of hypervirulence and drug-resistance emerged as a serious clinical problem , novel therapeutic strategies are worthy of investigation .', 'A problem with the currently available HDAC inhibitors is that they have limited specificity and target multiple deacetylases .', 'Target therapy has been one of the important strategies in new drug discovery and the resulting drug resistance has also been a serious problem for concern .', 'However , the emergence of mutants resistant or cross-resistant to nucleoside/nucleotide analogues remains a serious problem .', 'Understanding fluconazole resistance is important as it emerged as a serious clinical problem for this CYP51 , sterol 14alpha-demethylase , inhibitor .', 'Drug resistance is a serious concern in a clinical setting jeopardizing treatment for both infectious agents and cancers alike .', 'The development of drug resistance is a serious concern , because resistance is associated with rising viral loads and with poorer prognosis in advanced disease .', 'In quite a few diseases , drug resistance due to target variability poses a serious problem in pharmacotherapy .', 'Although current therapies offer favorable prospects for improving survival , the development of resistance remains a severe problem .', 'The instability of the hydroxylactone E \u2005 ring represents a critical drawback of camptothecins , because the lactone ring is recognized to be essential for stabilization of topoisomerase \u2005 I-mediated DNA cleavage .', 'High prevalence of important resistant phenotypes is of a serious concern .']


Cluster  134
['Malnutrition in childhood cancer is commonly a serious problem .', 'The diagnosis of the so-called " small-round-cell tumours " in children and adolescents is a troublesome problem , particularly in specific forms of the disease or/and in undifferentiated cell proliferations .', 'Drug resistance of childhood cancer neuroblastoma is a serious clinical problem .', 'Cancer in adolescents ( 15 to 19 years ) appears to be a serious medical , psychologic , ethical and economical problem as well .', 'The increasing magnitude of childhood cancer has become a threatening problem in developing countries like India .', 'Childhood cancer survivors ( CCSs ) from high-grade malignancies , such as high-risk neuroblastoma , have been increased , and second malignant neoplasm , becomes a serious problem for CCSs .', 'Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members .', 'The occurrence of prior , concurrent and subsequent neoplasms ( SN ) represents a serious problem in children and adolescents with soft tissue sarcomas .', 'Primary brain tumor is a leading cause of death in cancer-bearing children', 'In developing countries up to 77% of children with cancer have been shown to be malnourished on admission.', 'Pediatric cancer is a life-threatening disease that challenges the life of the diagnosed child , the parents , and possible siblings .', 'Malnutrition is a serious concern for children with cancer and nutrition screening may offer a simple alternative to nutrition assessment for identifying children with cancer who are at risk of malnutrition .', 'Gynecologic neoplasms are rare in children and represent only less than 5% of all childhood tumors']


Cluster  204
["Table 4 gives a breakdown of our system 's performance on the various category subtypes . it relies too much on the quality of sentiment lexicon and thus hard to cover the network language arose spontaneously", "Table 4 gives a breakdown of our system 's performance on the various category subtypes . it relies too much on the quality of sentiment lexicon and thus hard to cover the network language arose spontaneously", 'Having linguistic features enables the model to implicitly incorporate sentiment information into the word embeddings , helping to classify this example correctly . the need for large training data', 'Having linguistic features enables the model to implicitly incorporate sentiment information into the word embeddings , helping to classify this example correctly . the need for large training data', 'Having linguistic features enables the model to implicitly incorporate sentiment information into the word embeddings , helping to classify this example correctly . the need for large training data', 'The system tackles the effect of negations and quantifiers in sentiment analysis , and addresses the problem of word ambiguity', 'They showed that the best results were achieved using a built-in positive and negative lexicon and a bag-of-words as features . their need for always having two players , which requires them to sustain enough interest to always maintain an active pool of players']


Cluster  1842
['We performed a prospective study with 186 patients on PD followed up for 1 year.', 'A total of 105 PD patients in a Chinese tertiary hospital were enrolled and divided into a control group (35 cases), a WeChat group (intervention group 1; 35 cases), and a face-to-face group (intervention group 2; 35 cases).', 'AI is an effective therapy for severe motor response complications in PD, especially in the short and medium term.', 'OPG was the strongest risk factor associated with new development and rapid progression of AC in incident PD patients.', 'Randomized controlled single-blind trial with 30 individuals with PD.', 'Atherosclerotic vascular disease is frequent among asymptomatic patients undergoing PD.', 'In a tertiary-hospital, 93 AKI patients who required PD between May 2015 and January 2016 were enrolled in a randomized, open-label controlled study.', 'We included 18 patients with PD (age 30-80\u200ayears) who were at Hoehn and Yahr stages II-III.', 'Refractory heart failure was the most frequent cause of acute PD (49.', 'This is an observational study of patients with PD treated with AI between 2004 and 2014.']


Cluster  1684
['Reconstruction of the urinary tract because of ureteral stricture after kidney transplantation is a serious problem .', 'Allograft loss remains a severe clinical problem after kidney transplantation .', 'The exponential increase in the number of patients on the renal transplant waiting list globally has become a serious problem fueled by an increase in the number of patients with end-stage renal disease , the shortage of organs for transplant , and the failure of transplanted kidneys for various reasons .', 'Renal failure after heart transplantation ( HTx ) still remains a serious problem , especially when cyclosporin A is used for immunosuppression in the early postoperative therapy .', 'Third and fourth kidney transplants can be performed safely with similar outcomes to 1st and 2nd transplants.', 'The prevalence of end-stage renal disease is emerging as a serious worldwide public health problem because of the shortage of donor organs and the need to take lifelong immunosuppressive medication in patients who receive a transplanted kidney .', 'Post-transplant renal osteopathy ( ROP ) remains a serious problem , which contributes to substantial long-term morbidity of the graft recipients .', 'Twenty-two 3rd and 4th kidney transplants were matched with 22 first and 22\xa0seconds transplants.', 'Although the last few decades have seen major improvements in patient outcomes following kidney transplantation , the increasing shortage of available organs represents a severe problem worldwide .', 'Accelerated acute cellular rejection ( AR ) continues to be a serious problem in kidney transplantation ( KT ) , suggesting that undetected presensitization may be encountered .', 'For renal transplant recipient treated with ICIs , the increased incidence of rejection is a serious concern .', 'Acute renal failure is a serious problem following heart transplantation .', 'The presence of albuminuria after renal transplantation is common, especially in patients with proteinuria.']


Cluster  2324
['Anthropogenic nitrate contamination is a serious problem in many natural environments .', 'The elevated level of nitrate in groundwater is a serious problem in Korean agricultural areas .', 'Nitrate pollution in groundwater is a serious problem in many parts of the world .', 'Nitrate is a serious problem in closed-circuit public aquariums because its accumulation rapidly becomes toxic to many lifeforms .', 'Excess nitrogen ( N ) is a serious water-quality problem in most of the estuaries in the United States , especially those downstream of developed coastal basins .', 'The presence of nitrate in water and wastewater is a serious environmental problem .', 'Nitrate ( NO3(- ) ) pollution is a severe problem in aquatic systems in Taihu Lake Basin in China .', 'Nitrate ( NO(3-)N ) contamination of drinking groundwater is a serious worldwide problem .', 'Nitrate and nitrite contamination of surface waters ( e.g. lakes ) has become a severe environmental and health problem , especially in developing countries .']


Cluster  381
['As a main drawback of the VAT technique , the image quality was compromised by a blurring effect .', 'A drawback of these current techniques is that the field map scans and the measurement can capture different patient positions , which invalidates the stationary condition .', 'For discrete spot scanning , a major drawback of this method is the treatment time , which increases linearly with the number of re-scans .', 'A drawback of this method is that the total acquisition time and amount of data collected are increased ; hence , the data are susceptible to motion artifacts and decorrelation .', 'A common drawback of classical methods aiming at such modifications is the revealing of artefacts or the attenuation of details and textures .', 'Therefore , a fundamental problem with inverse treatment planning is that it may exhibit instabilities manifested in nonphysical oscillations in the beam intensity functions .', 'The extended methods , however , had a serious image quality problem due to the following three reasons : ( 1 ) excessively close slice positions of the complementary and direct data , resulting in a larger sampling interval ; ( 2 ) the existence of several discontinuous changeovers in pairs of data samples for interpolation ; and ( 3 ) the existence of cone angles .', 'One problem with the Carter method is that tissue edges occasionally freeze above the plane of the smooth cryostat disk .', 'A drawback of this technique is that unstable aberrations are lost after exposure .']


Cluster  1064
['Drug-resistant HIV is becoming a serious problem , even in treatment-naive patients .', 'HIV-1 protease inhibitors are effective in HIV/AIDS therapy , although drug resistance is a severe problem .', 'Despite advances in anti-retroviral therapy which has transformed HIV/AIDS from a fatal to a manageable chronic disease , increasing viral drug resistance , side effects and uneven access to anti-retroviral drugs remain considerable therapeutic challenges .', 'Emergence of multi-drug resistant HIV-1 is a serious problem for AIDS treatment .', 'Drug-resistance is a serious problem for treatment of the HIV/AIDS pandemic .', 'Although protease inhibitors ( PIs ) are a potent class of antiretrovirals , resistance can still develop rapidly , and multiple-PI resistance has become a serious , growing clinical problem .', 'Emergence of human immunodeficiency virus ( HIV ) drug resistance mutations prior to highly active antiretroviral therapy is a serious problem in clinical management of HIV/AIDS .', 'A serious problem in the treatment of HIV infection is the emergence of drug-resistant forms of the virus .']


Cluster  2225
['In last few decades , though significant progress has been made in the treatment and control strategies of tubercular infections by introducing new diagnostic and monitoring tools and combination therapy , it still continues to be a severe problem .', "Tuberculosis of the central nervous system possess a serious clinical and radiological problem , since early treatment of this condition is crucial for the patient 's life , and tuberculous process in the CNS may mimic many other pathologies .", 'Intracranial tuberculosis continues to be a serious problem in both the developing and developed world , with significant morbidity and mortality .', 'These data suggest that multidrug resistance in tuberculous meningitis is not yet a serious problem .', 'In recent years tuberculosis has reemerged as a serious public health problem , raising the possibility that tuberculous eye disease may also become more prevalent .', 'The pathophysiology underlying tuberculous meningitis ( TBM ) , the most prominent extra pulmonary tuberculosis and a serious public health problem in developing countries is still unclear .', 'Tuberculous meningitis ( tbm ) , although comparatively rare , remains a serious clinical problem .']


Cluster  1221
['This labeling violates C1 , the minimal hamming distance is 2 , and our approximation gives 1 , -LRB- since there is only one transition that violates the constraint . -RRB- all disagreements are treated equally', 'This labeling violates C1 , the minimal hamming distance is 2 , and our approximation gives 1 , -LRB- since there is only one transition that violates the constraint . -RRB- all disagreements are treated equally', 'This labeling violates C1 , the minimal hamming distance is 2 , and our approximation gives 1 , -LRB- since there is only one transition that violates the constraint . -RRB- all disagreements are treated equally']


Cluster  1642
['In total, 44.', 'Overall, 276 of 323 teeth (85.', 'A total of 197 of the 322 (61.', 'Of 804 SE episodes, 268 (33.', 'A total of 97.', 'A total of 47.', 'Overall, 61.', 'In total, 54 (67.', 'A total of 46 (61.', 'Among a total of 525 polyps, 415 (79.']


Cluster  55
['We did not find any robust evidence that GH treatment is associated with changes in cIMT.', 'In this pilot study, we were not able to show any difference between MET and ET.', 'RT seems not to influence QoL of BC patients, in terms of fractionation regimen or RT-related side-effects.', 'None of the variables investigated in this study showed a significant change after 8\xa0weeks of intervention with C. vulgaris.', 'There was no significant relationship between hospital volume and in-hospital mortality due to preterm PDA.', 'No correlation existed between the duration of SSC and the neonatal physiological variables of oxygen saturation, HR, RR, and temperature.', 'In this large observational cohort study, there was no association between waterbirth and specific adverse outcomes for either the mother or the baby.', 'This trial demonstrated no advantage of CCH treatment compared with PNF in terms of clinical outcome at any time during the 2-year follow-up.', 'To date, there is no prospective data available comparing these two navigation techniques.', 'There was no observable relationship between decreased dihydrotestosterone levels and BC diagnosis.', 'In patients with functioning KT, we found no correlation between blood levels of calcidiol and the incidence of cancer.', 'The modelled mean increase in survival with ivabradine was 0.', 'Of 157,290 active patients examined, 0.', 'Our results showed that there was no correlation of tCa/iCa ratio with TBil or INR.', 'Chile currently does not have sexually transmitted infections surveillance or screening programs for youth and adolescents.', 'Neither NT-proBNP nor cTnI concentrations were independently associated with measured GFR.', 'Age and gender had no clinically meaningful effect on the PK, PD, and safety of dotinurad.']


Cluster  961
['Treatment of the cachetic , hypoalbuminemic , peritoneal dialysis patient represents a vexing patient management problem .', 'Although fatigue among the dialysis population is known as a severe and debilitating health problem , this symptom is often under recognized and undertreated .', 'Protein-energy wasting ( PEW ) , a syndrome involving adverse changes in nutrition and body composition , is a serious problem associated with morbidity and mortality in patients with end-stage renal disease ( ESRD ) .', 'To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress.', 'Nonadherence to different aspects of ESRD continues to be a serious problem among dialysis patients , and it is closely linked to depression and anxiety .', 'Malnutrition is a serious and common problem among patients dialyzed with peritoneal dialysis .', 'Malnutrition of maintenance hemodialysis patients is a serious clinical problem , strongly and negatively affecting their outcome .']


Cluster  1501
['From current point of view , enriching the hint lists is also desirable . the tail model assigns a static preference to paraphrase ( i.e. , tail preferences are assumed to be contextindependent )', 'From current point of view , enriching the hint lists is also desirable . the tail model assigns a static preference to paraphrase ( i.e. , tail preferences are assumed to be contextindependent )', 'From current point of view , enriching the hint lists is also desirable . the tail model assigns a static preference to paraphrase ( i.e. , tail preferences are assumed to be contextindependent )']


Cluster  769
['This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010-2012) and in Denmark (n = 116) (DK) (2012-2014).', 'In the 77% of PAD patients diagnosed with dyslipidemia, 72% had hypertension and 31% had diabetes.', 'Diabetes mellitus is a serious health problem in Australia and if nurses are to effectively care for clients with this condition , they need to undertake specialised training in this area .', 'Thirty-eight per cent saw themselves at increased risk of diabetes and 34 % thought diabetes a serious problem .', 'Claims-based observational study with 1-year follow-up beginning 6 months after diabetes diagnosis.', 'Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus.', 'One in 280 Australians diagnosed with diabetes have a monogenic form; most are of European ethnicity.', 'Thirty-nine subjects ( 38.6 % ) were concerned about diabetes and 85 ( 84.2 % ) considered diabetes a serious problem .', 'To determine the prevalence of monogenic diabetes in an Australian community.', 'In recent years there has been a rise in the number of diabetic patients in Japan , with the increase in elderly diabetic patients becoming a serious problem .', 'This is the first study in middle-aged Japanese people to clarify an increased burden of CVD due to diabetes since the early 1990 s. Further efforts are needed to prevent and control diabetes through lifestyle modification and treatment.', 'The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at Hospital Universiti Sains Malaysia (HUSM) in Kelantan.', 'Diabetes mellitus is a serious and increasing health problem in Australia and is a designated national health priority .']


Cluster  1685
['Two part-of-speech language models were trained for that experiment : one on the language of children with SLI and one on the language of typically developing children . there is no information indicating how the word being defined binds to the relations in the qualia', 'Two part-of-speech language models were trained for that experiment : one on the language of children with SLI and one on the language of typically developing children . there is no information indicating how the word being defined binds to the relations in the qualia', 'Two part-of-speech language models were trained for that experiment : one on the language of children with SLI and one on the language of typically developing children . there is no information indicating how the word being defined binds to the relations in the qualia']


Cluster  1210
['In contrast , pneumoperitoneum due to visceral perforation represents a serious clinical problem and usually needs an urgent surgical intervention .', 'Mediastinitis secondary to esophageal perforation is usually a life-threatening problem associated with high morbidity and mortality .', 'Radiologically recognising pneumatisation and anatomical variations of the ACP may be helpful in decreasing the incidence of surgical complications during anterior clinoidectomy.', 'Postoperative radiographs demonstrating pneumoperitoneum are a vexing problem for surgeons .', "Retroperitoneal perforation of the duodenum , caused by abdominal trauma , endoscopic examination or diverticulitis , is a serious clinical problem , because of it 's lack of specific symptoms .", 'Perforation of the thoracic oesophagus is a serious clinical problem , associated with a high morbidity and mortality , especially if treated late .']


Cluster  529
['The problem with dietary and lifestyle interventions is that they are hard to implement .', 'Diet nonadherence remains a serious health problem and suffers from a lack of solid criteria to identify this condition .', 'Underreporting of energy intake is a serious and pervasive problem , especially among women with overweight and obesity .', 'Small sample size, short duration of intervention, changes in background diet during the intervention.', 'Under-reporting of food intake , a recognized drawback of this dietary method , would be sought retrospectively by reference to a key publication giving minimum cut-off limits for ratios of energy intakes to basal metabolic rates .', 'Measurement error is a serious problem in nutritional epidemiology because of the lack of gold standard measurements and results in biased estimated diet-disease associations .', 'In Western countries underestimation of energy intake ( EI ) is considered a serious problem in dietary surveys , but information on the accuracy of EI among Japanese people is sparse .', 'Carbohydrate counting caused significant error in the exchange number.', 'Misclassification or measurement error is a serious problem for all dietary methods , although for different reasons .']


Cluster  112
['All injuries in the International Ice Hockey Federation World Junior under-20 (WJ U20) Championship and under-18 (WJ U18) Championship were collected over a 9-year period using a strict injury definition, a standardised injury reporting system and diagnoses made by a team physician.', 'Orofacial injuries are a serious problem in field hockey .', 'The risk of injury among male junior ice hockey players was lower than the reported rates in adult men but higher than that in women.', 'Overuse injury including stress fracture is a serious problem for athletes .', 'Sports-related orofacial trauma is a serious problem that can be prevented by wearing protective mouthguards and headgear .', 'Ocular and facial injuries sustained by goaltenders in the National Hockey League : a preventable problem .', 'Despite various attempts at prevention , injury in downhill skiing continues to be a worrisome recreational problem .', 'Shoulder injuries from repetitive baseball pitching continue to be a serious , common problem .', 'Pitching injuries continue to be a serious problem , with adolescents now representing the group with the most injuries .', 'Frostbite , the severest form of cold injury is a serious medical problem for our Armed Forces operating in the snow bound areas at high altitude .', 'Overuse injuries are a serious problem in junior tennis .']


Cluster  563
['The exact skin cancer risk deriving from UVB-NB is a serious concern to be determined .', 'However , increasing the risk of skin cancer by phototherapy is a serious concern .', 'Skin cancer is a serious concern whose incidence is increasing at an alarming rate .', 'The patients with skin cancer, appropriate to their heightened skin cancer risk, appeared unlikely to increase their sun exposure to gain VitD.', 'Eighty-nine percent of the nurses reported that skin cancer was a serious problem , and 97 % believed that many people were at risk .', 'Patients (n = 10) previously treated for multiple basal cell cancer in a hospital setting participated in focus group sessions with semi-structured discussions to explore: knowledge of VitD, sun-avoidance behaviour and attitude towards sunlight exposure messages.', 'Skin cancer is a serious societal problem , and public awareness outreach , including to youth , is crucial .', 'Given the evidence for increased skin cancer risk due to the sunbed use, a regulation of hazardous artificial ultraviolet radiation (UVR regulation) was passed in Germany in 2012.', 'Skin cancer , the most commonly diagnosed cancer in the United States , is a serious health care concern .', 'Skin cancers including malignant melanoma which are due to UV radiation constitute a serious public health problem .', 'To explore the knowledge, behaviour and attitudes of patients with skin cancer to sunlight exposure and VitD sources.']


Cluster  1448
['In Colombia , with higher frequency of Plasmodium vivax over Plasmodium falciparum infection , recent reports confirmed gestational malaria as a serious public health problem .', 'Malaria during pregnancy remains a serious public health problem .', 'Malaria in pregnancy is a serious health problem that contributes greatly to maternal morbidity and mortality .', "Malaria infection during pregnancy is a serious health problem in most of the world 's tropical regions .", 'Placental malaria ( PM ) remains a severe public health problem in areas of high malaria transmission .', 'Malaria during pregnancy remains a serious public health problem .']


Cluster  1843
['Cutaneous leishmaniasis due to Leishmania major is a serious and increasing problem affecting many rural areas of 17 out of 31 provinces in Iran .', 'In Algeria , Human Leishmaniases ( HL ) are endemic and represent a serious public health problem because of their high annual incidence and their spread across the country .', 'Zoonotic cutaneous leishmaniasis due to Leishmania major is a serious public health problem in Algeria .', 'Cutaneous leishmaniasis is currently a serious public health problem in northern Africa , especially in Morocco .', 'Human leishmaniasis , both visceral and cutaneous , has been reported in Morocco for centuries and constitutes a serious public health problem .', 'Cutaneous leishmaniasis ( CL ) remains a serious public health concern in Kerman Province , eastern Iran .', 'Zoonotic Cutaneous Leishmaniasis ( ZCL ) is still a serious health problem in Iran .', 'Pakistan is one of the countries in which cutaneous leishmaniasis is becoming an epidemic disease and because of its morbidity and disfiguring scars , it is considered a serious public health problem .', 'Zoonotic Cutaneous Leishmaniasis ( ZCL ) due to Leishmania major ( L. major ) is still a serious public health problem in Tunisia .', 'Zoonotic cutaneous leishmaniasis ( ZCL ) constitutes a serious public health problem in many parts of the world including Iran .']


Cluster  1653
['Since all y-intercepts and gradients have a precision of two decimal places , we scale the linear functions ` e -LRB- \\u03b3 -RRB- by 102 and negate them to create tropical monomials -LRB- Step 3 -RRB- . the high expense of manually annotating the text', 'A tropical polynomial is the generalised sum of tropical monomials where the generalised sum is evaluated using the min operation . the resources they rely on require significant effort to create and will not always be available to model data in a new language or a new domain', 'Using a scaled version of fe -LRB- ` y -RRB- as the basis for a tropical monomial may cause negative exponents to be created . they are all negative tests , which are known to be problematic in language classification tasks']


Cluster  255
['Somatic comorbidities are a serious problem in patients with severe mental illnesses .', 'This study suggests that an 8-week aerobic dance program may be an effective intervention in patients with schizophrenia in terms of improving bodyweight, body mass index, flexibility, and cardiorespiratory endurance for a period of at least 4 months.', 'Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied.', 'The authors suggest that vomiting among schizophrenic patients is usually underestimated and may at times be a serious clinical problem .', 'Negative symptoms of schizophrenia constitute a serious diagnostic and therapeutic problem .', 'We enrolled 138 schizophrenia patients with involuntary admission from July 2008 to June 2013 and followed those patients for readmission outcomes at 3 months and at 1 year.', 'Apart from the inadequacy of the plasma neuroleptic assay method , resistance to neuroleptic treatment in some schizophrenics presents a serious problem in studies looking into the plasma drug level versus clinical response correlation .', 'Treatment-resistant schizophrenia is a serious clinical problem .', 'Auditory hallucinations are a serious problem for a large subgroup of psychotic patients who do not respond optimally to neuroleptic medication .', 'The heterogeneity within schizophrenia or the group of schizophrenias remains a vexing and limiting problem .', 'Schizophrenia patients with FRS randomly received either active or sham-magnetic resonance imaging navigated continuous Θ burst stimulation (cTBS)-rTMS to right inferior parietal lobule for 2 weeks; assessments were repeated.', 'Empirical evidence suggests that schizotypy is a useful construct for analyzing and understanding psychotic disorders', 'Deficits in N-methyl-D-aspartate receptor (NMDAR) function contribute to symptoms and cognitive dysfunction in schizophrenia and are associated with impaired generation of event-related potential measures including auditory mismatch negativity.', 'Standardised interviews with 63 outpatients diagnosed with schizophrenia were videotaped.', 'Study involved 80 hospitalized patients with any of the subtypes of schizophrenia (42 men, 38 women).', 'WHAT IS KNOWN ABOUT THE SUBJECT ? : Loneliness among people diagnosed with schizophrenia is a serious problem .', 'Individuals with schizophrenia having prominent negative symptoms and impaired neurocognitive performance (N\xa0=\xa035) were randomized to guided success (n\xa0=\xa019) or a control (n\xa0=\xa016) condition.', 'Despite the development of second-generation antipsychotic drugs , treatment-resistant symptoms still represent a serious problem in schizophrenia .', 'Forensic patients with schizophrenia who fail to adhere to prescribed antipsychotic medication risk recidivism , which continues to be a serious concern .', 'Suicide is a serious and extensive problem in the clinical management of schizophrenic patients .', 'Disordered interpersonal communication can be a serious problem in schizophrenia .', 'This Phase II, multinational, randomized, double-blind, placebo-controlled, parallel-group trial will randomize 200 clinically stable outpatients, aged 18-50\xa0years with established schizophrenia and no other major psychiatric disorder, 1:1 to BI\xa0425809 or placebo once daily for 12\xa0weeks.', 'Suicide risk in psychotic patients is a serious but poorly understood clinical and social problem .', 'The results indicate that deficits in MMN, P200 and P3B amplitude are present at early stages of schizophrenia, although depending on the paradigm used.', 'Despite the introduction of atypical antipsychotic drugs , treatment-resistant symptoms still represent a serious problem in schizophrenia .', 'Individuals with schizophrenia have lower levels of aerobic capacity compared to general population.']


Cluster  446
['SOES had positive therapeutic results for treatment of CTTH.', 'The rates of ΔALD and clinical ALD in this TDR population were similar to those previously reported in the literature for TDR at 5-year follow-up.', 'Twenty-nine patients received mTOR/CSA-based treatment and 51 patients received mTOR/TAC-based therapy.', 'From January 2013 to January 2018, TRAT was offered to 151 patients, of whom 65 (43.', 'TTNBs resulted in a change of clinical management in about one in every 10 patients; however, the associated adverse event risk was substantial.', 'A total of 52 patients underwent TaTME for malignant conditions.', 'TC with pQRSd is associated with poor in-hospital clinical outcome.', 'Thirty patients (3 men, 27 women) were randomly assigned to receive either high-energy ESWT (0.', 'Both PDT and TTT may be equally effective in the treatment of chronic CSC.', 'As part of an observational trial, TRAT was offered to patients with indication for a hemithyroidectomy because of benign goitre with a lobe volume up to 40\u2009ml.', 'A total of 981 consecutive patients from 2009 to 2014 were referred for preoperative EBUS-TBNA.', 'Severe TR might be a serious clinical problem in some patients .', 'Compared with TVr, TVR had acceptable early and late outcomes in patients with severe TR.', 'ESWT was efficacious and safe for treating patients with CRCT.', 'Renal disease becomes a serious problem for adults with TSC .']


Cluster  1745
['This implies that small concentration values are particularly uncertain , which can pose a serious practical concern as these are typically the earliest and latest to arrive at a point .', 'However , a problem with this type of study is that the variability estimates include measurement error .', 'Albumin influences the measurement , but for concentrations greater than or equal to 35 g/L this was not a serious problem .', 'Non-surmountable antagonism : a general drawback of pre-steady-state measurement ?', 'This poses a serious problem in comparing and evaluating the data from the two gradiometers .', 'A problem associated with probing measurement is that important site-specific change may be obscured by measurement variability .', 'Although the uncertainty estimate should be a necessary component of an analytical result , the presentation of measurements together with their uncertainties is still a serious problem , especially in the monitoring of the presence of pharmaceuticals in the environment .', 'A major drawback of this measurement method is caused by the fact , that the measuring gap tends to plug , which again limits the inline capability .']


Cluster  872
['Moreover , the lack of treatment was a serious problem mainly in rural areas .', 'A dreadful dilemma : individual versus global health perspectives .', 'It emphasizes how the lack of this condition being corrected in southern Brazil is a serious problem .', 'However , even following this intervention anaemia remained a serious public health problem and additional work to define and evaluate an effective intervention package is warranted .', 'Despite the failures of numerous diagnostic methods-even the definition of malnutrition defied consensus-health authorities remained convinced that malnutrition was a serious and widespread problem .', 'Thus , we identify a serious problem with so-called global health partnerships in which nation states and international organizations remain key actors .']


Cluster  1636
['The main drawback of applying this technique in dialectometry is that it is not directly related to the aggregate analysis , but is rather an independent step', 'As such , the following two hypotheses are applied : it is not directly related to the aggregate analysis , but is rather an independent step', 'As such , the following two hypotheses are applied : it is not directly related to the aggregate analysis , but is rather an independent step']


Cluster  1197
['The Huli of the Tari Basin have a serious problem with the spread of STDs following the opening of the Highlands Highway from Mendi in the early 1980s .', 'The STDs in children are a worrisome problem .', 'Sexually transmitted diseases are becoming a serious public health problem in China .', 'Sexually transmitted infections ( STIs ) are considered a serious public health problem worldwide , affecting especially young people .', 'Sexually transmitted infections are a serious public health concern worldwide , especially in young people .', 'Sexually transmitted infections are a serious health problem in Honduras .', 'However , participants acknowledged that STIs are a serious problem and recommended strategies for increasing participation in an STI testing and treatment programme .', 'Sexually transmitted infections ( STIs ) are a serious global health problem .', 'STIs are a serious public health problem .', 'There is an urgent need for the recognition of sexually transmitted infections ( STIs ) as a serious public health problem in Europe .', 'Sexually transmitted infections ( STIs ) remains a serious healthcare problem costing approximately 13 billion dollars annually to treat .', 'Sexually Transmitted Diseases are still considered a serious public health problem in Brazil and worldwide .', 'Our results suggest that STIs are a serious problem in Mongolia .', 'Sexually transmitted infections are a serious public health problem .', 'Since sexually transmitted diseases ( STDs ) are a serious health problem among youth , proper understanding of knowledge about STDs , beliefs about condom use and associated factors are public health necessities .', 'Available evidence indicates that STDs are a serious problem among adolescents ( 10 - 19 years ) , especially in rural areas where services are limited for any age group .', 'Sexually transmitted diseases ( STDs ) are a serious health problem for adolescents , occurring in an estimated one-quarter of sexually active teen-agers .']


Cluster  1270
['Balloon-occluded transcatheter arterial chemoembolization (B-TACE) using miriplatin (MPT) is anticipated as a new strategy for hepatocellular carcinoma (HCC).', 'This study was carried out on 50 patients with nonresectable single-lesion HCC, who were divided into three groups: group A included 20 patients treated by transcatheter hepatic arterial chemoembolization, group B included 20 patients treated by radiofrequency thermal ablation combined with transcatheter arterial chemoembolization, and group C included 10 patients treated by MWA combined with transcatheter arterial chemoembolization.', 'This study aims to analyze the curative effect of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating hepatic cell carcinoma (HCC) and its effect on serum markers.', 'Portal vein thrombosis (PVT) is a common complication after transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC).', 'Detection of hepatocellular carcinoma ( HCC ) in cirrhotic patients remains a serious , unsolved problem , and the risk factors for acute variceal bleeding ( AVB ) in HCC patients remain unclear .']


Cluster  284
['All patients with an eligible cardiovascular incident entered into the National Audit of Cardiac Rehabilitation (NACR) 1 January 2013-31st December 2015.', 'We conducted a multi-institutional RCT.', 'We interviewed 32 study participants (intervention: n = 15, control: n = 17) who completed the original RCT within the previous 6 months.', 'The RADIANT (NCT01974453) is a prospective, single-center observational study involving 4 expert operators and 2 fellows performing percutaneous coronary procedures.', 'A randomised controlled trial (RCT) comparing an intervention group receiving support from a RC with a control group receiving treatment as usual (TAU).', 'The study was a retrospective, observational cohort study using the Canadian Cardiac Rehab Registry (CCRR).', 'Using a convenience sample sourced from the original RCT, intervention and control group participants were invited to participate in a qualitative evaluation.', 'Data were retrospectively analysed from three cohorts administering the PACRR, a 19-item scale.', 'Exploratory secondary analyses of the CYCLE pilot RCT (NCT02377830).', 'A total of 124 nondiabetic RTRs participated in this study.', 'The RODEO study (NCT: 02972736) is an international observational retrospective multicenter study enrolling all patients undergoing diagnostic or interventional procedures performed by different interventional operators (i.e. radiologists, interventional cardiologists or electrophysiologists) in 6 centers, without exclusion criteria.', 'This multicentre RCT was performed between April 2012 and June 2014.', 'This was a prospective, multi-centre, single-arm, non-randomised study involving seven operators in five sites across Australia.', 'Eight Greek secondary and tertiary cardiology centres from different cities have participated in a prospective, observational survey, the ESC HF Pilot Survey.', 'This retrospective observational study analysed data registered during our telecardiology activity.']


Cluster  2301
['A larger shoulder flexion shortens per se exercise endurance due to the increased metabolic, ventilatory and cardiac response, without worsening dynamic hyperinflation.', 'The standing back extension exercise improved the shear modulus of the fatigued multifidus muscle.', "The results suggested that shoulder extension and internal rotation SS effectively decreased the infraspinatus muscle's hardness.", 'Changes produced in tendon and muscles structures after eccentric overload training and three consecutive running days were examined.', 'Passive shoulder measurements obtained from the uninvolved and involved shoulders were as follows: SHABD, 42° and 18°, respectively; SHADD, 14° and -1°, respectively; CBADD, 71° and 41°, respectively; and IRABD, 54° and 37°, respectively.', 'The strength of a normal shoulder differs according to gender and decreases with age.', 'Significant differences in joint angles were identified in the thoracic spine, elbow and shoulder at maximal weight.']


Cluster  627
['This review aims to provide a critical overview regarding the deactivation of sludge-associated pathogens by AD , through which a serious concern on the effectiveness and rationality of AD towards sludge pathogens control was raised .', 'To compare the effectiveness of an automated disinfection system with hydrogen peroxide <8% and silver ion versus a manual method with 0.', 'Although, in the current study, drug administration was continued for 72\xa0h maximum, the prescription of at most 4 doses of salbutamol may have had maximum efficiency in the remediation process.', 'The bacterial eradication rate of sputum in the intervention group (51.', 'Before disinfection, 13% of surfaces decontaminated with hydrogen peroxide and silver ions and 20% of surfaces decontaminated with sodium hypochlorite showed presence of C.\xa0difficile spores.', 'Peroral high doses of Salovum® rapidly and safely counteract diarrhea in children followed by a diarrhea-free period of 6 weeks.', 'The results of the study indicate that there was a statistically significant reduction in S. mutans and lactobacilli count in all the three study groups.', 'The differences between the groups were not statistically significant; however, the disinfection with hydrogen peroxide and silver ions is preferable due to less dependence on operators.', 'After 6 and 24 hours from the application, the microbial load observed in treated axilla was inferior in a statistically significant way compared to the untreated axilla.']


Cluster  1993
['We performed a prospective, observational study of adult ED patients undergoing POCUS of the right upper quadrant (RUQ) and serum laboratory studies for suspected biliary pathology.', 'Lymphatic drainage at 60 minutes was strongly dominant in the direction of the left colic pedicle (96% of patients), with a median gamma count of 284 (interquartile range, 113-413), versus the left branch of the middle colic count of 31 (interquartile range, 15-49; p < 0.', 'A prospective observational study was conducted in children (n\u2009=\u2009192) with suspected HD determined by radiological TZ on contrast barium enema, and who underwent pull-through operations.', 'Abdominal computed tomographic images of 168 hospitalized HF patients were retrospectively investigated for identification of average colon wall thickness (CWT) from the ascending to sigmoid colon.', 'A preoperatively determined radiological TZ has potential value to identify the length of resected bowel in patients with HD, and it also has a high predictive value for diagnosis of HD.', 'These findings suggest that EMPD images provide substantial agreement with X-ray confirmation and almost perfect agreement when the tip of the tube is within the small bowel.']


Cluster  837
['Inflammatory pain is a severe clinical problem that affects the quality of life in patients .', 'Arthritis-associated inflammatory pain represents a serious medical problem worldwide .', 'This study will evaluate the clinical efficacy of warming needle moxibustion in the treatment of ankylosing spondylitis.', 'Forty patients with chronic lateral epicondylitis were included in this clinical trial.', 'In patients with symptomatic SpA and naïve to GCs, low-dose MR prednisone reduced the symptoms and clinical indexes of disease activity and showed a positive safety profile.', 'This single-center cohort study retrospectively assessed the effectiveness and safety of 12-week low-dose MR prednisone (5 mg daily, bedtime administration) in GC-naïve adult patients with symptomatic axial SpA.', 'This study will evaluate the clinical efficacy of a silver needle in the treatment of rheumatoid arthritis.', "Chronic inflammatory pain is a serious clinical problem caused by inflammation of the joints and degenerative diseases and greatly affects patients ' quality of life ."]


Cluster  840
['To examine the association between weekday DRPs and recovery from fatigue by conducting a one-month observational study using a fatigue monitoring application (fatigue app) on a smart tablet.', 'There is a need to expand the research of cognitive strain, which poses a considerable risk to work performance and employee well-being in cognitively demanding tasks.', 'Ensuring weekday DRPs plays an essential role in protecting the opportunities to sleep, with better recovery from fatigue and stress among information technology workers.', 'Visual fatigue of VDT ( visual display terminal ) operators poses a serious problem for corporations where VDT work is a major part of operations .', 'Participants made significantly more errors when physically fatigued, whereas participants performed the test significantly slower when mentally stressed.']


Cluster  754
['Viral vectors are used commonly in gene therapy trials , but their potential toxic effects are a serious concern .', 'The impact of jet nebulization on DNA structural and functional integrity has been problematic for the aerosol delivery of genes to pulmonary sites and remains a serious concern for this otherwise promising and noninvasive approach .', 'A major drawback of current approaches to antiangiogenic gene therapy is the lack of tissue-specific targeting .', 'Lentiviral vectors ( LVs ) are powerful tools for stable gene delivery but their integration into undesired cell types poses a serious safety concern for their use in the clinic .', 'A potential drawback of recent antiviral therapies based on the transgenic expression of artificial microRNAs is the ease with which viruses may generate escape mutations .', 'To solve the problem of uncontrolled therapeutic gene integration , which is a critical drawback of retroviral vectors for gene therapy , the integration sites of exogenous genes should be precisely controlled not to perturb endogenous gene expression .', 'Such an occurrence , even when polyclonal CTL lines are used against genetically stable virus antigens , suggests that escape mutants may be a serious problem when CTL therapy is directed against more unstable tumor cell-derived targets .', 'To explore the possibility of using RNAi as a strategy against HEV infection , which is a serious public health problem in developing countries of Asia , Middle East , Africa , and in Mexico , after the fusion protein expression plasmids pEGFP-ORF3 which contain the EGFP reporter gene and SHEV ORF3 as silencing target , were constructed ; EGFP-ORF3 fusion protein expressing HEK 293 cell lines were established ; and four siRNAs targeting ORF3 gene were designed , synthesized , and used to transfect the stable cell lines .', 'The main problem with light activated RNA interference ( LARI ) to date is that the groups used only partially block RNA interference prior to irradiation , thus limiting the utility of the approach .', "Branched polyethylenimine ( bPEI ) has been considered as the ' gold standard ' for gene delivery but suffers a major drawback of exhibiting high cytotoxicity .", 'However , the delivery and cell uptake of siRNA pose a serious problem in its therapeutic application .', 'The identified polyplex micelles then faced a drawback of limited transfection efficiency due to the absence of free polymer , which is an acknowledged tendency found in various synthetic gene carriers .', 'A major drawback of this gene delivery method has been the lack of cell-type specificity .', 'A drawback of gene therapy using adeno-associated virus ( AAV ) is the DNA packaging restriction of the viral capsid ( < 4.7 kb ) .', 'Recombinant adenoviruses ( Ads ) are amongst the most efficient hepatotropic gene delivery vehicles , but a drawback of their use is transient transgene expression and toxicity that results from induction of host immune responses .', 'E. coli mediated gene delivery faces a major drawback of low efficiency despite of being a safer alternative to viral vectors .']


Cluster  1174
['Influenza in aging presents a serious clinical problem .', 'Seasonal influenza is a serious problem leading to elevated mortality in octogenarian and nonagenarian patients admitted to a general hospital .', 'Influenza virus infections represent a serious public health and economic problem , which are most effectively prevented through vaccination .', 'Circulating influenza was associated with sustained increases and peaks in delayed patient throughput and premature patient departures.', 'Effective vaccination against influenza virus infection is a serious problem mainly due to antigenic variability of the virus .', 'The emergence of oseltamivir-resistant 2009 H1N1 influenza virus ( conferred by the H275Y substitution in NA ) during therapy or prophylaxis in immunocompromised patients is a serious concern .', 'Influenza constitutes a serious problem for healthcare and social services worldwide , owing to its pattern and the severity of its complications in some categories of subjects at risk , such as the elderly and immunocompromised individuals .', 'During 2011-2014, peak annual circulating influenza was associated with the peak weekly proportion of presentations that left in >4 h. The maximum estimated absolute weekly change in that proportion was 3.', 'Influenza is a serious problem for infants < 6 months of age , whose hospitalization rates for influenza and associated illness are comparable with rates in the elderly .', 'Continuously evolving highly pathogenic influenza A viruses are a serious health concern which necessitates a coupling of theoretical and experimental approaches to predict the evolutionary trends of the influenza A virus , with a focus on the H5 subtype .', 'Influenza virus infections represent a serious public health problem worldwide , due to the rapid emergence of drug resistance .', 'Secondary bacterial infections after influenza can be a serious problem , especially in young children and the elderly , yet the efficacy of current vaccines is limited .', 'Seasonal influenza has become a serious public health problem worldwide , and vaccination is recognized as the most effective preventative measure .']


Cluster  1235
['Its major limitation is that it can only handle approximately 20 words or phrases', 'A common limitation is that the user may not find the exact sign ( or version of a sign ) that is needed for a particular sentence', 'Perhaps the most serious limitation is that they cannot be used to study language in natural tasks with real-world referents', 'But the limitation is that it required a dependency parser , thesaurus , and training data', 'A notorious problem with computational linguistics is that there is no path into it', 'The problem is that when we do this we actually increase the lexical sparsity', 'So far , we have not addressed the problem of unknown words', 'Hence , they are not long and most of them do not exhibit interesting linguistic properties', "And another shortcoming is that a small number of words in almost every resulting class does n't belong to the part-of-speech categories which most of words in that class belong to"]


Cluster  736
['Fifty-three patients received 100 RBC transfusions.', 'Twenty-three healthy donors (87% male) participated in the study.', 'Forty-nine consecutive donors (f = 6, m = 43) were included prospectively from the Capital Regional Blood Center.', 'The OPTIA CMNC collection procedure is safe and effective for the collection of CD34+ cells in G-CSF-mobilized donors and was superior to the COBE for CE1% and CE2%, collecting approximately 19 and 16% higher, respectively.', 'Fifteen adult and seven paediatric centres (75%) responded; 22·7% continue to provide components from CMV-seronegative donors.', 'Data were collected for 1,398 standard criteria donors.', 'This study included 1084 male and 792 female whole blood donors accepted for blood donation.', 'A total of 42 donors were included (84 grafts in total, but 1 discarded due to multiple cysts); 25 DBD and 17 cDCD without differences in age or sex.', 'This cross-sectional survey included 1191 blood donors from AP Vojvodina.']


Cluster  488
['Papulopustular rosacea and rosacea-like demodicosis have numerous similarities, but they are generally considered as two distinct entities, mainly because the causal role of the Demodex mite in the development of rosacea is not yet widely accepted.', 'According to our results a new really promising simple, safe and cheap treatment option targeting mainly to the vascular net and the erythema of rosacea is proposed.', 'Fractional microneedling radiofrequency (FMR) is an emerging treatment modality, but its effect on rosacea has not been studied yet.', 'Our observations highlight the difficulty differentiating between these entities and suggest that rosacea-like demodicosis and papulopustular rosacea should no longer be considered as two separate entities, but rather as two phenotypes of the same disease.', 'To investigate the potential impact of FMR treatment on clinical improvement and histologic changes in rosacea patients.', 'Thirty patients with rosacea (erythematotelangiectatic rosacea [ETR], n = 20; papulopustular rosacea [PPR], n = 10) were enrolled in a randomized, controlled, split-face study.', 'Demodex mites might have a role in acne pathogenesis in patients with polycystic ovary syndrome.', 'Rosacea is a common inflammatory facial skin condition.']


Cluster  899
["However , a review of researches on adults ' dropout shows that dropout is a serious problem for psychotherapy with adult patients .", 'Of those who began treatment, 50% did not complete treatment, and the presence of psychosocial and environmental problems predicted drop-out.', 'Most patients failed to improve in therapy at some point.', 'Research has shown that lack of treatment adherence is a serious problem , especially among patients with psychiatric disorders .', 'Although noncompliance represents a serious concern in long-term schizophrenia treatment , a detailed information on the factors that impair compliance is still limited .', 'Drop-out is a serious problem in psychotherapy .', 'Refusing to attend school is a serious problem that could lead to psychopathology .', 'Loss of follow-up information regarding the adjustment of people who have received mental health services has been a troublesome problem when comparing the effectiveness of different treatment programs .']


Cluster  1604
['Although the risk of the development of autoimmune polyglandular syndromes during pregnancy is small , they may pose a serious health problem .', 'Women with gestational diabetes mellitus are more likely to develop type 2 diabetes mellitus, and babies with gestational diabetes mellitus incur increased risk of neonatal hypoglycaemia and childhood obesity', 'Gestational diabetes mellitus ( GDM ) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus .', 'We showed that former PS patients who developed rPS have raised fibronectin- and reduced PAI-2-levels already in early/mid pregnancy.', 'Gestational diabetes mellitus ( GDM ) is a serious health problem associated with both foetal and maternal complications .', 'Association with recurrent pregnancy loss , intrauterine growth retardation , preeclampsia and placenta ablation makes ASP a serious perinatologic problem .', 'While PPROM at very early gestation is a serious complication and a major management dilemma often associated with poor outcome , the prognosis is not without hope .', '37 cases and 21 cases are in mild and severe ICP group respectively, of which, the incidence of gestational diabetes mellitus (GDM) and iatrogenic preterm delivery in severe ICP group are higher than those in mild ICP group.', 'Although unrecognized pituitary disorders may pose a serious health problem to the mother and fetus , hemochromatosis-induced diabetes insipidus , as the case of our patient demonstrates , if effectively diagnosed and treated , can not be regarded as a contraindication for pregnancy .']


Cluster  308
['To determine whether patients with cutaneous SCC have a higher prevalence of hypothyroidism than the general US population.', 'Patients with SCC of skin are more likely to have a history of hypothyroidism than the general population.', 'This pilot study was designed to evaluate the efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients.', 'This randomized clinical trial was performed on 30 patients with subclinical hypothyroidism who were referred to the endocrine clinics of Ghaem and Imam Reza hospitals in Mashhad, Iran.', 'Technetium thyroid uptake (TTU) is not inhibited by antithyroid drugs (ATD) and reflects the degree of thyroid stimulation.', 'TTU evaluation in hyperthyroid patients receiving antithyroid medication is an accurate and practical method for predicting relapse after ATD withdrawal.', 'Treatment with ashwagandha may be beneficial for normalizing thyroid indices in subclinical hypothyroid patients.', 'To determine whether the HPTA is suppressed after levothyroxine administration in euthyroid dogs and the time required for resolution of any suppression.', 'Permanent hypoparathyroidism is a serious problem and requires medications indefinitely .', 'Assessing thyroid function tests 1 week after cessation of levothyroxine at 26 μg/kg once a day for up to 16 weeks will provide an accurate assessment of thyroid function in healthy euthyroid dogs.', 'The frequent use of levothyroxine suggests that TSH suppression could represent a serious public health concern , particularly for postmenopausal women and patients with heart disease .', 'Levothyroxine had no significant effect on increasing the levels of serum osteocalcin in patients with subclinical hypothyroidism.']


Cluster  2220
['The problem with search coils is that many research laboratories still have their large and expensive coil systems installed and are acquiring eye movement data with old , analog technology .', 'The problem with muscle spindles as position sensors is that they are able to generate impulses in response to muscle length changes as well as from fusimotor activity .', 'A drawback of our current implementation is that position information is available for a single tracking coil only .']


Cluster  1710
['Kidney disease is a serious problem that adversely affects human health , but critical knowledge is lacking on how to effectively treat established chronic kidney disease .', 'Chronic kidney disease ( CKD ) is becoming a serious health problem throughout the world and is one of the most potent known risk factors for cardiovascular disease .', 'Steady increase in the prevalence of chronic kidney disease ( CKD ) is a serious public health problem , since CKD potentially leads to the development of end-stage renal disease ( ESRD ) that requires high-cost replacement therapy and is closely associated with increased risk of developing cardiovascular diseases ( CVD ) , which are the cause of death in most patients .', 'The inclining incidence of chronic kidney disease which has led to high mortality and immense medical burden over the past decades has become a distressing concern in epidemiology .', 'Chronic kidney disease ( CKD ) represents a serious public health concern .', 'Chronic kidney disease ( CKD ) is a serious health problem worldwide .', "Chronic kidney disease ( CKD ) is a serious health problem due to high mortality and morbidity , negative impact on the patients ' quality of life ( QOL ) , high diagnostic and therapeutic cost , and the burden on society .", 'Chronic kidney disease ( CKD ) is becoming a serious health problem ; the number of people with impaired renal function is rapidly rising , especially in industrialized countries .', 'Chronic kidney disease ( CKD ) is considered a serious worldwide public health problem , but data from developing countries are extremely limited .', 'Chronic kidney disease ( CKD ) is a serious medical problem and public health issue in Taiwan .', 'Chronic kidney disease ( CKD ) is a serious health problem with high morbidity and mortality , mainly attributable to cardiovascular risk .', 'Epidemiological data show that chronic kidney disease ( CKD ) is a serious social problem and nowadays is included amongst civilisation diseases .', 'Moreover , the global prevalence of patients with chronic kidney disease is gradually increasing , which poses a serious public health problem .', 'Kidney disease represents a serious global health problem .', 'The prevalence of chronic kidney disease ( CKD ) as a serious public health problem is growing in the elderly .', 'Chronic kidney disease ( CKD ) is a serious universal problem that is the main risk for several diseases including cardiovascular disease .', 'Chronic kidney disease ( CKD ) is becoming a serious health problem throughout the world and is one of the most potent known risk factors for cardiovascular disease , which is the leading cause of morbidity and mortality in this patient population .', 'Chronic kidney disease ( CKD ) poses a serious public health problem worldwide .', 'The progression of chronic kidney disease is accompanied by multi-organ disorders , among which cardiovascular diseases have the status of a serious clinical problem .', 'In 2013 , the PAHO Member States recognized the epidemic of chronic kidney disease of non-traditional causes ( CKDnT ) as a serious public health problem .']


Cluster  2172
["A severe clinical phenotype along with concern for ensuring normal growth and development has a major impact on treatment choices for children newly diagnosed with Crohn 's disease ( CD ) .", "Our results show that malnutrition is a serious problem also in outpatients with Crohn 's disease .", 'Sixty-four patients with ulcerative colitis and with a clinical Mayo score less than 3 for at least 3\xa0months were evaluated for anemia.', 'Anemia was seen in more than half of patients with ulcerative colitis in clinical remission, iron deficiency being the most common cause.', "There was no correlation between the Crohn 's disease activity index and serum or red blood cell levels of vitamin E. These findings suggest that the lowered serum vitamin E levels in patients with Crohn 's disease are a symptom of hypolipidemia , and that vitamin E deficiency may not actually become a serious problem in patients diagnosed with Crohn 's disease .", 'Serum zonulin concentration was higher in IBD patients compared to HC (34.', 'Combining histological features of ileitis and clinical variables can adequately discriminate between the presence and absence of Crohn disease in children who present with confluent colitis and ileitis.']


Cluster  1914
['P. acnes skin colonization remained similar to prior studies at 47.', 'Our findings indicate a similar colonization rate for pregnant and elderly women.', 'We found significant associations between the type of microorganism colonizing the skin and the epidemiological and clinical profiles of the donors.', 'Preadolescents with acne were colonized with a greater diversity of cutaneous bacteria than controls and the most commonly identified bacterium was Streptococcus.']


Cluster  13
['In particularly , hippocampal injury after ischemia-reperfusion is a serious problem as it contributes to vascular dementia .', 'Oxidative stress is correlated negatively with cognitive function and positively with postoperative ischemic lesions.', 'Cognitive impairment induced by cerebral infarction has become a devastating health problem .', 'Cerebral infarction survivors were randomly assigned to an experimental group (28 patients) or a control group (25 patients).', 'Cerebral ischemia/reperfusion injury is a severe problem in patients with brain ischemia .', 'Cerebral ischemia-reperfusion ( IR ) has attracted wide attention as a serious clinical problem .', 'Unfortunately , cerebral re-perfusion syndrome is a serious unresolved problem .', 'To study the effect of cavinton comforte (CC) on the severity of cognitive impairment and motor awkwardness in patients with chronic brain ischemia (HIGM).', 'Ischemic cerebral infarcts represent a serious health problem with important social and economic repercussions in the western world .', 'Cerebral hyperperfusion syndrome (CHS) and reperfusion injury are distinct pathological phenomena.', 'Inflammatory response that occur post-ischemia is a serious problem in the treatment of ischemic brain disease .', 'Reperfusion injury is a serious problem in ischemic stroke therapy , which leads to neuronal damage and intracranial hemorrhage ( ICH ) .']


Cluster  1074
['Atherosclerotic renal artery stenosis (ARAS) is frequently detected in patients with resistant hypertension (RHTN), but the evidence supporting the utility of renal revascularization in these patients is limited.', 'Despite the enormous progress that has been madein the fields of vascular surgery and intensive care , reconstructive surgery of renal arteries in the presence of arteriosclerosis of the abdominal aorta remains a serious therapeutic problem and is associated with a high rate of complications .', 'The 94 patients with renal dysfunction undergoing isolated coronary artery bypass grafting were retrospectively analyzed.', 'These results suggest that off-pump coronary revascularization offers a superior renal protection and has a significantly lower risk for renal complications in patients with nondialysis-dependent renal dysfunction when compared with conventional coronary revascularization with cardiopulmonary bypass.', 'The aim of the study was to investigate the nephroprotective effects of RIPC in coronary heart disease (CHD) in patients, undergoing CAG, with mild to moderate lowered estimated glomerular filtration rate (eGFR).', 'Therefore , in open abdominal artery aneurysm ( AAA ) repair in renal transplant patients , kidney ischemia due to a proximal aortic clamp is a serious problem .', 'Although patients receiving hemodialysis (HD+) have significantly different backgrounds, including a history of progressive atherosclerotic disease, compared with those not receiving hemodialysis (HD-), there are no studies evaluating the risks for loss of primary patency (PP) and need for target lesion revascularization (TLR) in HD+ patients following bare self-expandable nitinol stent (BSNS) implantation to femoropopliteal (FP) artery occlusive lesions, after adjusting for differences using propensity score (PS) analysis in observed characteristics between groups.', 'In patients with RHTN, stenting of hemodynamically significant ARAS decreases blood pressure, preserves renal function in a substantial proportion of patients, and improves LV structure and function, suggesting the opportunity for timely identification of ARAS in these patients.']


Cluster  1249
['An interventional crossover study with 42 CKD patients (21 men, 21 women) complaining of upper GI symptoms were recruited.', 'We studied 28 controls and 30 patients with stages 3\xa0-\xa04 CKD.', 'An observational study in adults with CKD (estimated glomerular filtration rate [eGFR] <60 mL/min/1.', 'The pharmacological effects and on-target AEs of CKD-712 increased relative to the dose increments.', 'The area under the effect-time curve of the cardiac index (AUEC<sub>CI</sub>) and systolic blood pressure (AUEC<sub>SBP</sub>) changed significantly with the 160 and 320\xa0µg/kg doses of CKD-712 compared with placebo.', 'Data on 698 patients with preoperative CKD stage III and IV were analyzed: 99 received SPL preoperatively and 599 did not.', 'A dose-block-randomized, double-blind, placebo-controlled, single-dose escalation study was conducted in 44 healthy subjects receiving 20, 40, 80, 160, 240, or 320\xa0μg/kg CKD-712 or placebo.']


Cluster  797
['Cardiotoxicity is a major drawback of anticancer therapies , often hindering optimal management of cancer .', 'Although a high incidence of major hypersensitivity reactions due to the Cremophor EL vehicle used in formulation disrupted and almost terminated the clinical development of paclitaxel , hypersensitivity reactions are no longer a serious problem consequent to the advent of effective premedication regimens and longer administration schemes .', 'We demonstrate a decrease in blood permeability following bevacizumab and paclitaxel using DCE-MRI and a correlation between ΔKtrans and tumour regression.', 'Although paclitaxel is a frontline antineoplastic agent for treatment of solid tumors , the paclitaxel-evoked pain syndrome is a serious problem for patients .', 'Cardiac side effects are a major drawback of anticancer therapies , often requiring the use of low and less effective doses or even discontinuation of the drug .', 'Trastuzumab is generally well tolerated although cardiotoxicity has been observed , especially when in combination with doxorubicin ( Adriamycin ) , where this can be a serious concern .', 'Acquired resistance to doxorubicin in breast cancer is a serious therapeutic problem .', 'Doxorubicin cardiotoxicity remains a serious problem in children with malignancy .']


Cluster  620
['Fifty-four patients with idiopathic CTS were randomly divided into three groups.', 'Seventeen patients with SONK, confirmed by MRI, participated in this retrospective analysis.', 'Sixty patients with CTS were included in this study.', 'Computed tomography scans of 262 patients included in a placebo arm of a prospective, multicenter trial were used for a semi-quantitative analysis of white matter changes.', 'uSpD was detected by MRI in 69 of 79 patients (87%).', 'A total of twenty-three patients and eighteen healthy volunteers were examined with BOLD MRI.', 'Whereas significant differences were detected for clinical, functional and ultrasonographic imaging findings in each group in the 2nd week and 6th week compared to baseline (p< 0.', 'The patients were mostly young with a serious underlying medical problem ; MRI abnormalities were localized primarily in the posterior vascular boundary zones .', 'While accurate diagnostic decisions are dependent on the incorporation of all of the pertinent information gathered during the history and physical exams, the results of the CTS-6 may help the clinician focus their thinking and revise their diagnostic probabilities.']


Cluster  783
['However , a drawback of the previous Diels-Alder ligation is that the widely used maleimide moiety as a typical Michael acceptor can readily undergo Michael addition with nucleophiles in living systems .', 'A general drawback of chemical α-fucosylation is that the chemical assembly of α1,6-linked fucosides is not stereospecific .', 'In a practical operation of the reaction system , the formation of lyso-phospholipids from hydrolysis is often a serious problem , as demonstrated from previous studies .', 'A potential problem with this approach is that the acidic conditions used to carry out the reaction may hydrolyze other acyl esters , resulting in ex-vivo artifacts .', 'To address a key drawback of Laurdan linked to its rapid internalization and subsequent labeling of internal membranes , we redesigned it by introducing a membrane anchor group based on negatively charged sulfonate and dodecyl chain .', '(18)F-Galacto-cyclo(RGDfK ) is a well investigated tracer for imaging of ανβ3 expression in vivo , but suffers from the drawback of a time consuming multistep synthesis that can hardly be established under GMP conditions .', 'The problem with using lectins for studying O-glycosylation is that they are not sufficiently specific .', 'A drawback of this ligation- desulfurization approach is the removal of any unprotected native cysteine residues within the ligated protein segments .', 'Since umpolung α-imino esters contain three electrophilic centers , regioselective alkyl addition with traditional organometallic reagents has been a serious problem in the practical synthesis of versatile chiral α-amino acid derivatives .']


Cluster  2046
["One problem with a medicolegal autopsy , however , is that judicial institutes often refuse to disclose coroners ' reports .", 'Lack of transparency and adherence to recommended reporting practices constitute a serious problem in German economic evaluations .', 'The problem with large auditoria is that they discourage dialogue between students and faculty and they burden participation .', 'The problem with this suggestion is that it presupposes marketing information such that service providers can market their services for identified client needs .', 'The problem with some of these proposals , which treat all types of spaceflight the same , is that they are so restrictive that too few people would be eligible for space travel to have a viable tourism industry .', 'A major problem with traditional job descriptions is that they do not contain enough information for value integration to occur .', 'However , a problem with discussing privacy protection in terms of a research versus nonresearch model is that it is difficult to make this distinction for many kinds of projects .']


Cluster  387
['GSK805 ( 1 ) is a potent RORγt inverse agonist , but a drawback of 1 is its low solubility , leading to a limited absorption in high doses .', 'A descriptive, robust and predictive parent-metabolite model has been developed using a population mixed-effects approach to characterize the pharmacokinetics of nefopam and its metabolites simultaneously in healthy subjects following oral administration of nefopam.', 'The oral administration of amphotericin B ( AmB ) has a major drawback of poor bioavailability .', 'To determine and compare pharmacokinetics of itraconazole in dogs after oral administration of commercially available capsule and solution formulations intended for use in humans.', 'Pharmacokinetic data for the parent and metabolites were analyzed simultaneously using NONMEM<sup>®</sup> (nonlinear mixed-effect modeling) v7.', 'The final structural model simultaneously described the plasma and urinary pharmacokinetics of nefopam and the two metabolites.', 'ATP-driven pumping of a variety of drugs out of cells by the human P-glycoprotein poses a serious problem to medical therapy .', 'A 2-compartment pharmacokinetic model with first-order absorption fit MOD-4023 data well; a 1-compartment model was appropriate for r-hGH.', 'These results suggest that GFJ increases the extent of absorption and reduces clearance of dapoxetine possibly by inhibition of both intestinal and hepatic CYP3A4, whereas PJ has little effect on dapoxetine pharmacokinetics.', 'The mean relative bioavailability of the capsule was 85% that of the solution, but drug absorption was variable, and overall drug concentrations were similar between formulations.']


Cluster  2047
['Our study confirm that digital dermoscopy follow-up is a valid management strategy for patients with multiple atypical nevi, with short-term monitoring playing an effective role also in this setting of patients.', 'The aim of this retrospective, observational study was to evaluate the impact and reliability of a schedule combining STFU and LTFU in patients with multiple atypical nevi.', 'We searched our database for all cases of patients with multiple atypical nevi occurring between 2006 and 2014.']


Cluster  78
['Pseudo-accommodation has a high prevalence among non-amblyopic pseudophakic children.', 'A randomised control trial was performed on patients with amblyopia aged 4-8\u2005years with three arms.', 'During the 15-year period , there was a remarkable increase in the prevalence of high and very high myopia among high school students , which might become a serious public health problem in China for the next few decades .', 'Visual rehabilitation by conventional aphakic spectacles and contact lenses has posed a serious problem in the pediatric population .', 'Myopia has increased worldwide during recent years and is becoming a serious public health problem .', 'Myopia in school children is a serious public health problem in Chongqing .', 'A cross-sectional study of 50 amblyopic patients (20 strabismic and 30 anisometropic) and 50 controls was done.', 'Irreversible or intractable amblyopia secondary to severe anisometropic myopia is a serious medical concern in the pediatric population .', 'Myopia has become a global public health problem']


Cluster  534
['Two hundred forty-five patients with SAP in total were randomly assigned into four groups according to the therapeutic plan: basic treatment; LPLD; CVVDH; or LPLD+CVVDH.', 'Totally 64 SAP patients were included in our study and randomly assigned into PCD+PD group (the combination group, N.=32) and convention group (N.', 'Compliance with the SAP protocols in our hospital is high.', 'The incidence of SAP in the SCU NBC Hospital was higher than that in the SCU NCVC (22.', 'The combination treatment of PCD and PD effectively relieves the clinical symptoms of SAP by clearing plasma inflammatory cytokines.', 'LPLD and CVVDH are effective in the treatment of SAP by eliminating endotoxin, TNF-α, IL-6, and IL-8.', 'A total of 1,346 patients were exposed to a SAP between January 2010 and December 2014; 27 (2%) had a SI.']


Cluster  1819
['Twenty-four healthy university students (50% male) participated in a cross-over, randomized study.', 'This observational and cross sectional study involved a total of 3329 healthy adults of 18-79 years of age.', 'Thirty healthy participants aged between 18 and 35 years will be included.', 'This randomized, educational intervention study was performed on 41 AS patients.', 'This study was an internet-based, self-administered survey, conducted in randomly selected adults aged ≥40 years.', 'This was a randomised pre- and post-intervention study of 22 HSSP participants and 19 matched healthy controls.', '75 healthy participants aged 19-55 years were recruited over a 4-month period.', 'We analyzed data from population-based intervention study, in which a random sample of 1000 persons aged ≥75 years were randomized to either an intervention group or a control group.', 'A total of 100 participants were included in this study and randomized to either a face-to-face or online intervention.', 'Eighteen healthy male adults were assigned to either an intervention or control group.']


Cluster  33
['The 6-minute withdrawal time for colonoscopy, widely considered the standard of care, is controversial.', 'There were no significant group differences in overall colonic transit [GC48, 2.', 'After 24\xa0h of treatment, the median number of stools was 3.', 'Our aim was to evaluate the effect of moderately high-protein enteral formula containing fibre on nutritional status, and its safety.', 'Controversy remains regarding the type and amount of precapsule bowel cleansing required for small-bowel video capsule endoscopy (VCE).', 'This study investigated the efficacy and safety of an enteral feed formulation containing fibre.', 'Small-bowel cleansing for VCE remains a controversial topic.', 'Bowel preparation with castor oil was effective for improving capsule excretion rate and reducing liquid loading.', 'Standard bowel cleansing for colon capsule endoscopy ( CCE ) requires a liquid diet and bowel laxatives for at least 2 days , which is a major drawback of this procedure and affects tolerance and acceptability .', 'To evaluate the efficacy of supplemental preparation in bowel cleansing quality among patients with Bristol stool form 1 and 2, as well as the feasibility of tailored bowel preparation guided by Bristol stool form scale.', 'The cleanliness of the colons was not significantly different among the 3 split-dose preparations.', 'The optimum intervals for bowel preparation are identical for all preparations.', 'The results of bowel preparation using Aquanet EC-2000® were similar to using Mannitol solution.', 'There were significant differences in favour of no bowel preparation compared with suppository group for the primary outcome; days to first defecation.']


Cluster  1256
['Study results confirmed the satisfactory diagnostic value of CCI in detecting depleted iron stores in blood donors.', 'Anaemia is prevalent prior to THA and TKA with iron deficiency as the most common and reversible cause.', 'Iron overload before the availability of epoetin constituted a serious problem ; our review of the literature does not decisively conclude that these patients had more serious bacterial infections or increased mortality when compared with their non-iron overloaded counterparts , unless chronic transfusion-related hepatic disease was superimposed .', 'The aim of this study was to assess the appropriateness of using combined cell index (CCI) in the assessment of iron stores in blood donors.', 'This post hoc analysis of the EPIC study compared serum ferritin and LIC in 317 patients with transfusion-dependent thalassaemia before and after 1 yr of deferasirox.', 'Women with a postpartum haemorrhage exceeding 1000 ml and an Hb between 5·6 and 8·1 g/dl were randomized to 1500 mg of intravenous iron (n = 7) isomaltoside or RBC transfusion (n = 6).', 'To evaluate the clinical efficacy of a single-dose intravenous infusion of iron isomaltoside compared with current treatment practice with oral iron measured by physical fatigue in women after postpartum haemorrhage.']


Cluster  1171
['Although in recent years the number of the therapeutic options available for all types of skin lymphoproliferative disorders, in particular mycosis fungoides, has increased considerably, there are few studies concerning UVA1 phototherapy.', 'The aim of this Austrian single center study was to retrospectively investigate over a 4-year time period the frequency of PLE in patients prone to the condition and patients with other diseases under phototherapy (mainly narrow-band and broad-band UVB).', 'A drawback of standard PDT using Photofrin ( ® ) as photosensitizer is the long lasting skin photosensitivity of up to 3 months .', 'To determine the safety and efficacy of daylight PDT in a series of patients with AC.', 'The authors compare low fluence photodynamic therapy (PDT) against graded subthreshold transpupillary thermotherapy (TTT) for chronic central serous chorioretinopathy (CSC).', 'To assess and compare the efficacy of psoralen plus ultraviolet A (PUVA) and narrowband ultraviolet B (NB-UVB) in steroid-dependent CRU.', 'The aim of this study was to assess the effect of UVB nb and UVA phototherapy in combination compared against UVB nb monotherapy on pruritus, disease activity and quality of life.', 'Treatment significantly improved tolerance to UV exposure as evidenced by increased MED at 4 and 8\xa0weeks compared with baseline (P\xa0<\xa0.', 'We conducted a descriptive cross-sectional study of 35 patients with photosensitivity reactions confirmed by photopatch testing at the Research Center of Hospital Público San Martín in La Plata, Argentina, in 2015 and 2016.', 'Therapeutic doses of ultraviolet radiation are relatively safe in dark skinned patients; however, minimizing the cumulative dose of phototherapeutic modalities (particularly psoralen plus ultraviolet-A) is recommended.', 'Phototherapy with UVB nb alone, and UVB nb combined with UVA are equally effective in treating inflammatory skin disease and indifferent in reducing disease-associated pruritus.', 'In a national French study, we sought to investigate the influence of sun exposure on EPP symptoms.', 'Patients exposed to UVA-1 phototherapy showed a decrease in the SCORAD (30.', 'UVA-1 phototherapy can be an alternative for patients with severe atopic dermatitis even at lower doses than those described in other series (30\xa0J/cm<sup>2</sup> ) and not only for acute flares.']


Cluster  1072
['The main problem with polymeric heart valves ( which are already biocompatible ) is that they usually fail in the long term owing to tearing and calcification of the leaflets under high dynamic tensile bending stress and oxidative reactions with blood .', 'Calcification of glutaraldehyde-preserved bioprosthetic cardiac valves represents a serious clinical problem .', 'With the possibility to implant long vessel segments using antiproliferative drugs to prevent restenosis , the practice of transforming the coronary vessels into stiff tubes with a full metal jacket covering all side branches and being unable to adjust to the long-term wall changes , including wall remodeling with lumen ectasia becomes a serious concern .', 'A major drawback of mechanical and prosthetic heart valves is their inability to permit somatic growth .', 'Calcification of bioprostheses used for heart valve replacement is a serious problem , since it causes bioprosthetic dysfunction .', 'Although a variety of strategies have been developed to enhance the structure and function of engineered cardiac tissues , an inherent limitation with traditional myocardial patches is that they do not permit evaluation of the fundamental relationships between pressure and volume that characterize global contractile function of the heart .', 'A drawback of this tissue-engineering method remains the limited availability of suitable autologous endothelial cells ( EC ) , especially in aged patients .', 'On one end of the spectrum is the pulmonary autograft , which comes closest to achieving these goals , but creates a double valve procedure for single valve disease , while on the other end are the mechanical valves and stented tissue valves , which allow easy " off the shelf " availability as well as easy implantability but are limited by the potential drawback of causing intrinsic obstruction to some extent because of the space occupied by the stent and sewing ring .']


Cluster  422
['Chagas disease ( CD ) caused by Trypanosoma cruzi remains a serious public health problem in Latin America .', 'Africa Trypanosomiasis remains a serious health problem , but the approved drugs for this disease are so few that novel trypanocidal compounds are demanded .', "Chagas ' disease is a neglected disease caused by the protozoan parasite Trypanosoma cruzi and constitutes a serious health problem worldwide .", 'Chagas disease , caused by the parasite Trypanosoma cruzi , is a serious health problem in Latin America and is an emerging disease in non-endemic countries .', 'Trypanosoma cruzi transplacental infection represents a serious public health concern in all the countries like Chile where recent success of insecticide spraying programs eliminated the vector .', 'Trypanosoma cruzi , responsible for Chagas disease , is a serious public health problem in Latin America with eight million people infected in the world .', 'Chagas disease , also known as American trypanosomiasis , is a chronic and systemic parasitic infection which has become a serious epidemiological problem not only in endemic regions ( Latin America ) , but also in non-endemic ones like North America , Europe , and Oceania .', 'Human African trypanosomiasis ( HAT ) , commonly known as sleeping sickness has remained a serious health problem in many African countries with thousands of new infected cases annually .', 'American trypanosomiasis or Chagas disease ( CD ) is a vector borne pathology caused by the parasite Trypanosoma cruzi ( T. cruzi ) , which remains a serious global health problem .', 'Chagas disease is a serious public health problem in Latin America where about ten million individuals show Trypanosoma cruzi infection .', 'In the Gran Chaco region of Argentina , Bolivia , and Paraguay , vector transmission of Trypanosoma cruzi , the etiological agent of Chagas disease , is still a severe problem because , among other causes , houses are reinfested with Triatoma infestans , the main vector of T. cruzi in southern South America .', "Trypanosoma cruzi is the causative agent of Chagas ' disease , a parasitic disease that remains a serious health concern with unsatisfactory treatment .", "Chagas ' disease , caused by the protozoan Trypanosoma cruzi , represents a serious health problem in Latin America , and the available chemotherapy , which is based on 2 nitro-derivatives , is not satisfactory .", 'Chagas disease is a serious problem of parasitic disease in the American continent , this zoonosis is caused by the flagellated protozoan known as Trypanosoma cruzi and transmitted through trypomastigotes present in the blood of sick hosts or in the faeces of the triatomines .', 'Chagas disease is a serious public health problem in Ecuador , where nearly 230,000 individuals show Trypanosoma cruzi infection .', 'Although Trypanosoma rangeli is harmless for humans , it is a serious problem since it may be confused with diagnosis of Trypanosoma cruzi , the etiologic agent of Chagas disease .', 'Chagas disease , which is caused by the intracellular protozoan Trypanosoma cruzi , is a serious health problem in Latin America .']


Cluster  1
['-LRB- Typically no more than five sequences were removed . -RRB- depth-boundedness is undecidable', 'a -LSB- i k -RSB- is the substring of a from space i to space k , where the space before the first symbol is space zero . it requires us to be disciplined in our pass/overgeneration annotations', '= 1 - I -LRB- t -RRB- is defined by some execution of the subroutine search in the path -RCB- . data privacy issues', '-LRB- dictionary -RRB- No price for the new shares has been set . parameter estimations are usually based on plain text items only', 'Thus -LRB- Inst boyl boy - -RRB- asserts that boyl is a member of the set of boys , denoted by boy - . structures may not be properly represented by flat features', "tion of the rule for ` rel marker ' , at the node marked -LRB- * -RRB- in the figure . the heavy cost of inferencing", 'a -LSB- i k -RSB- is the substring of a from space i to space k , where the space before the first symbol is space zero . it requires us to be disciplined in our pass/overgeneration annotations', '-LRB- Typically no more than five sequences were removed . -RRB- depth-boundedness is undecidable', 'The second line is the output of the second stage of Xtract , it is a multiple word collocation -LRB- or n-gram -RRB- . these features give no information about where in the string the n-grams should occur', "The function ' go ' takes a pair of -LRB- action label , start position -RRB- and returns the end position or null if the action can not be executed at the start position according to the map . the negative instances far outnumber the positive ones"]


Cluster  443
['Propensity score matching showed that LLR for CRLM may provide R0 resection rates and long-term OS comparable to those for OLR, with lower blood loss and morbidity, and shorter postoperative hospital stay.', 'This was a single-centre retrospective study using a prospective database of patients undergoing liver resection for CRLM between August 2004 and April 2015.', "In our cohort, 15 patients had RFA-induced Glisson's capsule-associated complications (incidence of related complications, with some overlap: lasting AP fistula, n = 9; major intrahepatic bile-duct dilatation, n = 7; and hepatic infarction, n = 2).", 'CCLL is frequent in CS and independently associated with worse clinical outcomes irrespective of the revascularisation strategy.', 'Percutaneous interventions, including hepatic vein stent placement with or without balloon angioplasty, were performed in 21 patients who had undergone LDLT and had HVOO confirmed through hepatic venography or manometry, including the patients who had a structural abnormality.', 'However , biliary complications in RL-LDLT remain a serious problem : the incidence of anastomotic biliary leakage and stricture after RL-LDLT is reported to be 4.7%-18.2 % and 8.3%-31.7 % , respectively .', 'Patients with CRLM were prospectively randomized to receive open or laparoscopic liver resection (NCT03131778).']


Cluster  1679
['In 2007 , measles prevailed among the youth and young adult population in Japan , creating in a serious social problem .', 'Our study indicated that the adult measles cases have become a serious problem in Wujin district , which may mainly relate to the increasing size of the floating population with low measles vaccine coverage .', 'Mumps still remains a serious public health problem with a high incidence in China .', 'Measles still represents a serious public health problem worldwide .', 'Measles is a serious but preventable public health problem ; appropriate strategies must be devised by national and international public health officials to control the disease in developing and developed countries .', 'Measles is an infectious disease that represents a serious public health problem worldwide , being associated with increased susceptibility to secondary infections , especially in the respiratory and gastrointestinal tracts .', 'Measles is still a severe problem in eastern Turkey .']


Cluster  2373
['A limitation of this study , as with any survey-based research , is that selection and recall bias may have been present .', 'Risk of bias was a serious problem for most studies , decreasing the level of evidence .', 'Furthermore , the introduction of bias is a serious concern in the interpretation and validation of studies , often limiting their utility .', 'Potential bias in random selection is a major drawback of studies performed to-date .', 'One major limitation with balancing on the margins of the stratification variables is that there is an efficiency loss when the primary analysis is stratified .', 'A drawback of this strategy is that population stratification can bias the estimates .', 'However , a drawback of this approach is that regression parameters are assumed to be the same across observations , which could contribute to biased parameter estimates .']


Cluster  965
['The results of this study showed that one session of DN targeting active MTrPs appears to reduce hyperactivity of the sympathetic nervous system and irritability of the motor endplate.', "Drug-induced dyskinesias are a major drawback of the dopaminergic therapies currently employed to treat Parkinson 's disease .", 'A significant problem with this strategy is that many candidate medications possess abuse liability because of activation of mesolimbic dopamine ( DA ) neurons in the brain .', 'A problem with this gain control is that monoaminergic input to the cord is very diffuse , affecting many motor pools simultaneously , probably including both agonists and antagonists .', 'Despite the obvious benefits of l-DOPA treatment , a potential drawback of such a treatment is its potential for neurotoxicity .', 'In addition , psychiatric conditions often manifested as compulsive behaviours , are emerging as a serious problem in the management of L-dopa therapy .', 'Adjustment of the noradrenaline dose to the wide range of everyday stress and the possible occurrence of adrenoreceptor desensitization , however , remains a severe problem .']


Cluster  1423
['Recently , syntax-based models such as transitionbased parser have been used for detecting disfluI want a flight to Boston um to Denver sparse training resources', 'Recently , syntax-based models such as transitionbased parser have been used for detecting disfluI want a flight to Boston um to Denver sparse training resources', 'Recently , syntax-based models such as transitionbased parser have been used for detecting disfluI want a flight to Boston um to Denver sparse training resources']


Cluster  2005
['Attention bias modification may normalize brain function related to attention and anxiety in patients with IBS.', 'To examine the prevalence and outcomes of IBS and BCA patients treated with cognitive behavioural therapy (CBT) for anxiety disorders within a routine IAPT service.', 'Anxiety disorders with co-morbid IBS improved significantly in a routine IAPT service.']


Cluster  2284
['Patients with liver cirrhosis and ascites have a poor prognosis with increased risk of infection related death, as advanced stages of cirrhosis are associated with immunodeficiency.', 'Almost 20% of cirrhotic patients with ascites have HPA (>20\u2009g/l).', 'The management of ascites is a serious postoperative problem in patients with liver cirrhosis .', 'The aim of this study was to describe and compare the characteristics and prognosis between cirrhotic patients with HPA (>20\u2009g/l) and patients with low-protein ascites (LPA).', 'The occurrence of refractory ascites in nearly 17% of patients with decompensated cirrhosis is an unresolved issue.']


Cluster  1038
['Both lag screws and double Y-shaped miniplates provide favorable means of fixation for mandibular fractures in the anterior region.', "Consecutive patients with isolated zygomatic arch fractures with a minimum of 6 months' follow-up were studied in five groups: group 1, intraoral approach (no fixation); group 2, temporal approach (no fixation); group 3, coronal flap plate fixation; group 4, external splint fixation; and group 5, no surgery.", 'To compare the effectiveness of lag screws <i>vs</i> double Y-shaped miniplates in the fixation of anterior mandibular fractures.', 'This study is a prospective randomized controlled clinical trial, performed on sixteen patients with anterior mandibular fractures.', 'Mandibles fractures are one of the most frequent pathologies treated in an Oral and Maxillofacial Department and represent a serious public health problem .']


Cluster  876
['This effect is a serious concern for investigators who use NOD mice for diabetes research because the expected incidence of disease decreases markedly when they are colonized by SFB .', 'Diabetes mellitus is a serious world health problem and one of the most studied diseases ; a major concern about its treatment is that β-cell mass and functionality is hard to restore .', "The rising worldwide incidence of diabetes , combined with the lack of reliable endpoints of the body 's true capacity to produce insulin , constitute a serious dilemma facing healthcare professionals and the pharmaceutical industry .", 'Although it is recognized that Warburg effect confers growth advantage to cancer cells when glucose supply is sufficient , this feature could be considered as a fatal weakness of cancer cells when glucose supply is a problem .', 'Although limited success has been made to control insulin gene expression in ectopic cells using hormone/glucose-regulated expression systems , these transcriptionally regulated systems are relatively slow in the " on- " and " off"-kinetics of insulin production , raising a serious safety concern for clinical application .', 'A possible drawback of the mixture is a time- and temperature-dependent propensity to cause the formation of soluble , higher-molecular-weight insulin polymers , which apparently have lower biologic activity .', 'A significant drawback of the exogenous administration of insulin to diabetics is the non-physiological profile of insulin action resulting in the insufficient suppression of hepatic glucose production , which is the main contributing factor to diabetic hyperglycemia under fasting conditions and the basis of the challenge to restore a more physiological glucose profile in diabetes .', 'Native glucagon-like peptide-1 ( GLP-1 ) , which makes β-cells competent and diabetic β-cells specifically more sensitive to glucose , has a major drawback of rapid inactivation .', "Insulin's discovery 100 years ago and its ongoing use since that time to treat diabetes belies the molecular complexity of its structure and that of its receptor"]


Cluster  857
['However , aggression of the reactive oxygen species ( ROS ) and concomitant termination of the activity of biomolecular motors during investigation remains a drawback of this assay .', 'Transcription of Nrf2 target genes NADPH:quinone oxidoreductase-1 (NQO1) and heme-oxygenase-1 (HO1) was measured using Taqman® assays.', 'A drawback of this reductase activity is the diversion of valuable NADPH away from biosynthesis .', 'In crayfish ( Procambarus clarkii ) , the utility of redox proteomics as a novel biomarker was evaluated in the aquatic ecosystems of DNP and its surroundings , where agricultural activity is a serious concern .', 'The problem faced in oxidation state determinations with wet chemical methods is that U redox state may change when extracted from the sample material , thereby leading to erroneous results .', 'To overcome such a drawback of oxidase/POx bienzyme sensors , it is expected to be essential to decrease the rate of the oxidase reaction .']


Cluster  515
['Thirty patients with plaque psoriasis were taken up for a 12 week, open-label, right-left intra-individual clinical trial.', 'In a phase 2b, double-blind, vehicle-controlled study, adults with plaque psoriasis were randomized to tapinarof cream 0.', 'Loss of efficacy is a major anticipated shortcoming of utilizing etanercept and other biologic agents for treating moderate-to-severe psoriasis.', 'Treatment with oxymatrine effectively ameliorated severe plaque psoriasis, and was accompanied by only minor adverse effects.', 'Twenty patients with psoriatic plaque on right side treated by laser and another plaque on left side similar in size and its severity score served as control receiving no treatment.', 'In this open-label clinical trial, a 300\xa0mg bolus dose of azathioprine was given once every week orally for 24\xa0weeks to patients with chronic plaque psoriasis having body surface area involvement of ≥\xa010% and Psoriasis Area and Severity Index (PASI) of ≥\xa010.', 'Evaluation of the therapeutic effect of pulsed dye laser in treatment of chronic psoriatic plaque lesions and changes in human beta defensin-2(HBD-2) expression in the psoriatic patients before and after treatment, with correlation to the clinical improvement.', 'The objective of this study was to evaluate the therapeutic effectiveness of weekly oral pulse doses of azathioprine for the treatment of chronic plaque psoriasis, and to determine the side effects of this regimen both clinically and biochemically.', 'Sixteen patients with psoriasis vulgaris receiving a narrow band phototherapy were included.', 'The aim of this study was to determine the average duration of the drug-free interval between etanercept treatment cycles in patients with plaque psoriasis.', 'Within 12\u2009weeks of ixekizumab treatment, all signs of psoriasis across all body regions reached clinically meaningful improvements, with the head/neck and trunk responding quicker than psoriasis of the arms and legs, especially with reduced scaling and thickness.', 'Greater body mass index at the initiation of biological treatment for psoriasis may contribute to its decreased short-term efficacy.', 'Biological agents provide a relatively safe and promising long-term therapeutic option for patients with moderate to severe psoriasis in whom conventional treatment has failed.', 'A combination of calcipotriol and narrow-band ultraviolet B (NBUVB) has been shown to have a superior efficacy as compared to NBUVB alone in psoriasis.', 'Considerable improvement can be achieved with short-term potent topical corticosteroid treatment even in patients with severe, extensive psoriasis.', 'We sought to assess the efficacy of tofacitinib for the treatment of nail psoriasis over a period of 52\xa0weeks.', 'In this population, the SI rate for biologic and nonbiologic systemic agents was clinically indistinguishable, thereby supporting consideration of the entire spectrum of available systemic therapeutic agents, both biologic and nonbiologic agents, for management of moderate to severe psoriasis.', 'Patients were enrolled in a Phase 3 study comprising a 16-week double-blind, placebo-controlled period, a 17-week open-label period for Week 16 Psoriasis Area and Severity Index (PASI) 75 responders, and a 19-week double-blind, placebo-controlled period for Week 33 PASI 75 responders.', 'The lack of standardized outcomes for topical psoriasis treatments limits the ability to compare the results to other treatments.', 'To explore the efficacy and safety of intravenous oxymatrine in patients with severe plaque psoriasis.', 'Adult patients with psoriasis were selected from a large US administrative claims database (from the first quarter of 2000 through the third quarter of 2014) and classified in 2 mutually exclusive cohorts based on whether they were treated with TNFis or phototherapy.', 'Examine the efficacy of ixekizumab in clearing psoriasis within different body regions.', 'Even though the traditional therapy for nail psoriasis has been used for decades, no randomized, controlled trial of such treatment has been conducted to date.', 'We performed a retrospective observational study of all patients who received biological treatment for psoriasis at the Royal Melbourne Hospital (N\xa0=\xa0146).', 'Weekly azathioprine pulse appears to be an effective treatment for chronic plaque psoriasis, and can be used as an alternative therapy to other available therapeutic agents.']


Cluster  314
['Acute lung injury ( ALI ) is a severe inflammatory condition that develops in response to local and systemic lung challenges .', '1 . Acute lung injury ( ALI ) or acute respiratory distress syndrome is a serious clinical problem with high mortality .', '[ Pediatric acute respiratory distress syndrome : a severe problem than yet to be conquered by critical care medicine ] .', 'In this retrospective observational study, 83 patients with ARDS and 129 non-ARDS patients on ICU admission were enrolled.', 'Despite improvements in critical care , acute respiratory distress syndrome ( ARDS ) remains a devastating clinical problem with high rates of morbidity and mortality .', 'A tapering regimen after high-dose corticosteroids is likely to increase ventilator dependency and might aggravate the prognosis of patients with ARDS diagnosed according to the Berlin definition.', 'Acute lung injury ( ALI ) and the subsequent multi-system organ failure is a serious health problem with devastating impacts on the health care systems .', 'Since HPTs are frequently given therapeutically to patients with ARDS , a serious concern clinically has been the possibility that platelet transfusions might worsen pulmonary function in such patients .']


Cluster  353
['Drowsy driving is a serious highway safety problem .', 'Underage driving poses a serious problem in terms of crash outcomes .', 'Car accidents due to unexpected forward or backward runaway by older drivers are a serious social problem .', 'Riding with a drinking driver ( RWDD ) is a serious concern that leads to numerous preventable deaths every year .', 'Speeding-related crashes continue to be a serious problem in the United States . According to the National Highway Traffic Safety Administration , 26 % of all fatal crashes in 2017 had speeding as a contributing factor .', 'Unlicensed driving is a serious problem in many Australian states , with unlicensed driving-related crashes ( UDC ) costing up to $ 304 million per year in Queensland , and $ 176 million in Victoria .', 'Drunk driving is still a severe traffic safety problem to be addressed in China .', 'Drowsy driving is a serious public health concern which is often difficult for individual drivers to identify .', 'citations are still a serious concern among drivers aged 16 - 20 \xa0 years and have been shown to be related to increased risk of fatal and nonfatal crashes .', 'Women are increasingly involved in drunk driving and fatal crashes, yet except for the screening performed in criminal justice settings, little is known about their life context, psychiatric histories, and family backgrounds', 'An on-road observational study was conducted in Victoria, Australia.', 'In recent years , given the advance in connectivity and social networks , the use of smartphones while driving has become more frequent and a serious problem for safety .', 'While there is a strong emphasis for older people to maintain their mobility , the safety of older drivers is a serious community concern .', 'Drinking and driving are still a serious concern on the roads , even though the last twenty years has seen an increase in exposure to various designated driver programs .', 'A serious health problem is developing from automobile collisions caused by distracted drivers .', 'Among preventable causes of MVCs involving teenage drivers , distracted driving continues to be a serious public health problem .', 'Underage drinking and driving is a serious behavior problem reported by male and female youth .', 'Road rage has become a serious concern in many countries , and preventive efforts are required .', 'Driving under the influence of drugs is a serious road safety problem .', 'Work zone traffic safety under adverse weather conditions has been a serious concern for drivers and transportation agencies .']


Cluster  1472
['Bronchoscopic cryobiopsy was performed in a hybrid CT theatre.', 'To report the preliminary experience of using CT-fluoroscopic guidance for accurate targeting of bronchoscopic transbronchial cryobiopsy.', 'Multifocal nitrous oxide cryotherapy using CbFAS is a promising, highly effective, and safe endoscopic treatment for primary or rescue therapy of BE-associated neoplasia and IM.', 'Our preliminary experience confirms the feasibility of performing transbronchial cryobiopsy under CT-fluoroscopic guidance.']


Cluster  1363
['Veteran populations are exposed to multiple stressful events , and suicidality among veterans is a serious problem .', 'Research has shown that the likelihood of ex-military personnel developing mental health problems following service is around one in five', 'Violence toward others is a serious problem among a subset of military veterans .', 'Depression is a serious problem among military personnel returning from combat deployments , and is related to a range of adverse outcomes including alcohol and drug abuse , family violence and suicide .', 'Posttraumatic stress disorder ( PTSD ) is a serious and global problem , a psychiatric disorder that frequently occurs with different comorbidities , and is associated with a high suicide rate .', 'Although PTSD may be a serious problem in some survivors of critical illness , data on the whole population are inconclusive .', 'Post-traumatic stress disorder ( PTSD ) is a serious problem not only among workers who experience industrial accidents but also among workers who witness such accidents .', 'Posttraumatic stress disorder ( PTSD ) is a severe problem among soldiers with combating experience difficult to treat .', 'This could be a serious problem for military or emergency personnel recalled to combat or a disaster site without sufficient time to deal with the effects of their initial experiences .', 'Post Traumatic Stress Disorder ( PTSD ) can be a debilitating problem in service members who have served in Iraq or Afghanistan .', 'Violence toward others has been identified as a serious postdeployment adjustment problem in a subset of Iraq- and Afghanistan-era veterans .']


Cluster  1294
['The results indicated that therapist perfectionism may be less common than previously suggested.', 'Thirty-six therapists took part in the study; levels of perfectionism were measured using a self-report questionnaire and these were analysed in relation to the clinical outcomes from a sample of their clients.', 'This study aimed to measure perfectionism in High Intensity Cognitive Behavioural therapists, and establish any relationships between dimensions of therapist perfectionism, client outcomes and drop-out rates in treatment.', 'The psychological literature suggests that therapist perfectionism is common and potentially detrimental to client recovery.']


Cluster  1941
['MPI of the left ventricle was significantly higher in the SGA group as compared to AGA babies during all the three measurement periods with SGA babies having significantly higher MPI of right ventricle on day 1 and day 2 but not on day 3.', 'Heart rates of preterm infants in the experimental group were statistically significantly lower (Experimental: 139.', 'Even in early childhood, children born preterm had significantly elevated BP, compared with their term-born counterparts.', 'EKG provides an earlier, and more accurate heart rate than pulse rate from an oximeter during stabilization of preterm infants, allowing earlier intervention.', 'The aim of this study was to determine and compare changes in arterial oxygen saturation (SpO<sub>2</sub> ) and heart rate (HR) in healthy term infants with and without maternal bonding.', 'Neonatal heart rate at 10min was significantly higher (mean difference 4.', 'Ephedrine, compared to phenylephrine as a vasopressor during cesarean delivery, was associated with higher neonatal heart rate in the early post-birth period, but without a significant difference in clinical outcomes in uncomplicated pregnancies.', 'In low-risk full-term infants, HR was measured five times per minute in minutes 1-5 after delivery using the FDD and Neo-ECG, and their equivalence compared.']


Cluster  1976
['Twenty-one patients with DOR were included in the final analysis.', 'we enrolled twenty-four PSP patients.', 'Twenty-three residents completed the study.', 'Twenty patients were enrolled in the study.', 'Twenty-one patients completed the study.', 'A total of 20 patients participated in this sub-study.', 'We enrolled 22 patients.', 'Twenty patients were recruited prospectively.', 'The study was conducted on 20 healthy participants.', 'A total of 22 patients were included.', 'Twenty-eight subjects completed the study.', 'A total of 22 subjects completed the study.']


Cluster  1751
['Flushing, hemodynamic variables, and plasma 6-keto-PGF<sub>1α</sub> were recorded during the abdominal part of open ( n\u2009=\u200925) and robotically assisted ( n\u2009=\u200925) esophagectomy.', 'Microdialysis results showed that patients with upper gastrointestinal tract lesions had significantly higher levels of postoperative intraperitoneal glucose and glycerol concentrations, as well as lower lactate/pyruvate ratios and lactate/glucose ratios.', 'Patients undergoing either laparoscopic or open resection showed a similar preoperative GLR, as well as similar GLRs, on postoperative days (PODs) 1 and 3.', 'During upper laparotomy, microcirculation at the corpus decreased by 25% from baseline to mobilization of the stomach (p\u2009=\u2009.', 'The GLR status not only correlates with SS but may also be a reliable predictor of ICs for gastric cancer patients after gastrectomy.', 'Pretreatment with hydrocortisone ameliorated shedding of heparan sulfate, a major constituent of the endothelial glycocalyx, in patients undergoing cardiac surgery with cardiopulmonary bypass, but had no relevant influence on various clinical parameters or patient mortality.', 'Measuring the endothelial glycocalyx constituents in circulating blood could be a marker of intraoperative volume overload during laparoscopic operations.', 'Gastric microcirculation was assessed prior to and after reconstruction of gastric continuity in 25 consecutive patients operated for adenocarcinoma with open Ivor-Lewis esophagectomy while hemodynamic variables were recorded.']


Cluster  728
["The study compared three preparation practices for a target vegetable (spinach) on their effectiveness in increasing preschool-aged children's preference for and intake of the target vegetable in comparison to a control vegetable (green beans).", 'We used sensory testing to validate milk, egg white, and hazelnut recipes for use in DBPCFC.', 'We developed 3 recipes for use in DBPCFC with milk, egg white, and hazelnut and used the triangle test to validate them in a 2-phase study in which 197 volunteers participated.', 'In phase 1, the egg white recipe was validated (n=89 volunteers, 38.', 'We conducted a randomized controlled trial with four parallel groups: plain spinach, creamed spinach, spinach ravioli, and green beans.']


Cluster  1592
['Sarcopenic obesity ( SO ) is a serious public health concern , few studies have examined the clinical implications of SO in newly-diagnosed type 2 diabetes mellitus ( T2DM ) patients .', 'The high prevalence of obesity is a serious public health problem that is expected to affect the already high prevalence of Type 2 diabetes and its complications .', 'The prevalence of impaired glucose tolerance (IGT) is rising among obese adolescents in parallel with epidemic obesity.', 'Obesity , a major risk factor for chronic diseases such as type 2 diabetes ( T2D ) , represents a serious primary health problem worldwide .', 'In the last years , type 2 diabetes mellitus ( T2DM ) and obesity have become a serious public health problem , behaving as epidemic diseases .', 'Disordered eating is a serious and under-recognized problem in people with diabetes .', 'Obesity is a common nutritional disorder , associated with a variety of chronic diseases , among them , type 2 diabetes ( T2DM ) has emerged as a serious worldwide health problem .', 'Growing evidence support that insulin resistance may occur as a severe problem due to chronic energetic overfeeding and subsequent obesity .', 'Binge eating in simple obesity has recently been recognized as a serious clinical problem .']


Cluster  502
['Chronic infections are a serious health care problem , and bacterial persisters have been implicated in infection reoccurrence .', 'Microbial pathogenesis is a serious health concern .', 'Thus , overcoming microbial infections have again become a serious clinical problem .', 'and antibiotics from other classes , presenting a serious problem in treating invasive infections .', 'Furthermore , systemic infection remains a serious concern in bacteria treatment .', 'Pathogenic bacteria have become a serious socio-economic concern .', 'Bacterial infectious diseases are currently a serious health problem , especially in patients compromised by illness or those receiving immune-suppressant drugs .', 'Colistin resistance is considered a serious problem , due to a lack of alternative antibiotics .', 'According to the etiological microorganisms and antimicrobial susceptibility patterns, colistin was found to be the most reliable antibiotic for empirical antimicrobial therapy.', 'It remains a serious public health problem arising from its multidrug-resistant and extensive antibiotic resistance spectrum .', 'Long-term survival of bacterial pathogens during persistent bacterial infections can be associated with antibiotic treatment failure and poses a serious public health problem .', 'The severe morbidity and mortality associated with infection in the compromised host is a serious problem .', 'Opportunistic infections remain a serious concern , with a number of reports of death related to ciclosporin .', 'It is a serious clinical problem and poses a threat to the effectiveness of conventional antibiotic therapy .', 'Bacterial infection is a serious problem threatening human health .', 'Microorganism pollution induced by pathogens has become a serious concern in recent years .', 'Despite cART , non – AIDS-defining bacterial infections are still a serious problem .', 'Even today they constitute a serious problem , in spite of modern antibiotic treatment , with a potential risk of lethal complications .', 'Bacterial infections remain a serious health concern , in particular causing life-threatening infections of hospitalized and immunocompromised patients .']


Cluster  2185
['Recurrent pregnancy loss ( RPL ) is a serious problem for pregnancy .', 'Recurrent pregnancy loss is a vexing problem facing many couples .', 'The recurrent abortion syndrome has been considered a serious obstetrical problem , since it was not possible to diagnose the causes in over 40 % of the cases .', 'Recurrent miscarriage is a serious clinical problem that affects 1 - 5 % of all couples trying to conceive .']


Cluster  1579
['The emergency department on-call backup crisis : finding remedies for a serious public health problem .', 'Use of ambulances for nonemergency and routine transportation is thought to be a serious and growing problem .', 'Experts say under-triage is a serious problem in EDs across the country , and the issue has serious implications for patient outcomes .', 'Overcrowding of emergency rooms still a serious problem for Georgia hospitals .', 'Emergency department ( ED ) crowding is a serious problem in most tertiary hospitals in Korea .', 'Emergency medical services ( EMS ) personnel attrition is a serious concern .', 'Failure to rescue , or the unexpected death of a patient due to a preventable complication , is a nationally documented problem with numerous and multifaceted contributing factors .', 'Hospital and emergency department overcrowding is a serious and growing problem nationwide .', 'Despite the focus during the last decade on introducing interventions such as senior doctor initial assessment or senior doctor triage (SDT) to reduce emergency department (ED) crowding, there has been little attempt to identify the views of emergency healthcare professionals on such interventions']


Cluster  1214
['Repeated measures analysis of variance indicated that taking acetylsalicylic acid orally had significant main effect on high shear blood viscosity and red blood cell deformability index (P\u200a<\u200a0.', 'Quercetin Phytosome® does not alter the antiplatelet activity of the most common antiplatelet agents, has no impact on the INR values in stable patients treated with warfarin or dabigatran, and does not influence the metabolic control of diabetic patient treated with metformin.', 'Interaction with antiplatelet therapy was assessed through the bleeding time (BT) test in 30 patients treated with acetylsalicylic acid, ticlopidine or clopidogrel before and after 10 days of supplementation with Quercetin Phytosome®.', 'This study aimed to examine the influence of oral acetylsalicylic acid on blood fluidity and infusion speed in the cancer patients with Peripherally Inserted Central Catheter (PICC).']


Cluster  1651
["A total of 15\xa0CI adult listeners with more than 2\xa0years' CI experience participated in the auditory training.", 'Coren and Hakstian ( 1990 ) identified a serious methodological problem that arises in auditory research because of interaural correlation .', 'In a comparison of measurement methods (outcome parameters), the hearing improvement measured using constant sound pressure levels for speech audiometry was significantly greater and therefore more sensitive than using constant sensation levels.', 'The results of the present study revealed that AVQI is a robust multiparametric measure which can accurately discriminate across the subcategories of the perceptual dysphonia severity with reasonable precision.', 'Congenital amusia , characterized by a severe problem in detecting anomalies in melodies , is a lifelong disorder that has been ascribed to an acoustical pitch deficit .', 'Masking from background noise is often a serious problem when hearing levels are measured at or near the low reference threshold levels specified in the American National Standards Specifications for Audiometers , ANSI S3.6 - 1969 .', 'The two groups of listeners yielded comparable scores when their responses were examined by word, vowel, and final consonant.', 'Mean speaker discrimination score for the CI users was 74.', 'Patients with hearing aids with EB-NLFC had a significantly better word and consonant recognition using the MMRT (p<0.', 'Music perception shows deficits in CI users compared to normally hearing persons.', 'In this study, the influence of speech-audiometric outcome parameters on the outcome reporting of hearing therapies is studied.', 'This poses a serious problem for the investigator who wants to perform research on music with hearing impaired individuals who wear hearing aids .']


Cluster  2390
['The current findings suggest that environmental asbestos exposure continue to be a serious health concern in the Gaziantep region of Turkey .', 'By the early 1900s there was evidence that the asbestos substituted for the man-made mineral fiber insulation material employed to improve the thermal efficiency of steam powered engines , presented a serious health problem .', 'High concentrations of airborne asbestos in the ambient air are still a serious problem of air quality in numerous localities around the world .', 'To determine whether local environmental exposure to asbestos in the community of Hof van Twente , The Netherlands ( which houses a large asbestos cement facility and has a serious environmental asbestos pollution problem ) , is accompanied by an increased mortality due to pleural mesothelioma among women .', 'Results confirm that over eighteen years after the entry into force of Law 257/1992 , which established the cessation of all activities related to asbestos , asbestos-related diseases continue being observed in clinical practice and represent a serious public health problem .']


Cluster  1023
['We included 57 and 93 subjects with COPD and asthma, respectively.', 'Although there has been a slight reduction in mortality in recent decades , COPD is still a serious health problem that has enormous costs and utilizes significant medical resources .', 'The alarming rate of mortality and disability due to Chronic Obstructive Pulmonary Disease ( COPD ) has become a serious health concern worldwide .', 'Two hundred seventy-seven patients diagnosed with AS or COPD aged 18 to 69 (M=60.', 'Chronic obstructive pulmonary disease ( COPD ) is a serious and mounting global public health problem .', 'Chronic obstructive pulmonary disease ( COPD ) still remains a serious public health problem , which is a common cause of disability and death in the able-bodied population .', 'Introduction : Chronic obstructive pulmonary disease ( COPD ) is the main cause of progression chronic pulmonary heart ( CPH ) , it is a serious worldwide problem .', 'This retrospective observational study enrolled 234 participants (patients with COPD and pulmonary infection, patients with COPD without pulmonary infection, and healthy individuals) from January 2017 to December 2019.', 'In an observational study, we included patients with chronic respiratory disease.', 'There were significant differences among the COPD, asthma, and healthy control groups.', 'Chronic obstructive pulmonary disease ( COPD ) and its consequences in terms of disability and mortality are , in current practice , a serious public health problem whose prevalence is unknown in Algeria .', 'An online cross-sectional observational study was done with the participation of patients diagnosed with AS or COPD.', 'COPD is one of the most common causes of death globally and it is still a serious public health problem worldwide .', 'The depression risk is associated with a history of depressive disorder and medical comorbidity in patients with AS and COPD.']


Cluster  2371
['Hepatocellular carcinoma ( HCC ) is a common cancer that affects people worldwide with high morbidity and mortality , and its resistance to current chemotherapeutic drugs is a serious concern .', 'Hepatocellular carcinoma ( HCC ) is a primary malignant tumor of the liver that represents a serious public health problem all over the world , corresponding to the third cause of cancer death worldwide .', 'Treatment of liver malignancies , in particular hepatocellular carcinoma , remains a serious problem because of the difficulty of delivering adequate therapeutic agents to the lesions while sparing the surrounding normal tissue .', 'However , drug resistance is a serious problem in the treatment of hepatocellular carcinoma ( HCC ) .', 'Advanced hepatocellular carcinoma ( HCC ) is a serious public health problem , with no effective cure at present .', 'Hepatocellular carcinoma ( HCC ) is a serious health problem worldwide because of its association with hepatitis B and C viruses .']


Cluster  2270
['The problem with this approach is that it may suggest inflated results .', 'A problem with much of this research is that it fails to differentiate between historical time and future time .', 'A major problem with these equations is that they allow the physiological age to move back in time .', 'A common drawback of most methodological approaches is that interpretation of experimental results is based on simplified theoretical models of blood .', 'The major limitation associated with analytical techniques is that they are often only applicable to problems with simplified assumptions .', 'One major problem with such a comparison is that the efficacy of the historical control is treated as a known constant , whereas in reality , it is never precisely known .', 'There is a serious problem , however , with this use of correlations .', 'A problem with this approach is that the assumption of equality of mean and variance rarely holds in real data , which often show overdispersion .']


Cluster  368
["We perform extensive tests with different classes of functions and levels of data quality , including Monte Carlo data suffering from a severe sign problem and physical data for the Green 's function of the Fröhlich polaron .", 'Frustrated antiferromagnets are important materials whose quantum Monte Carlo simulation suffers from a severe sign problem .', 'A workaround is the use of effective theories like the Langevin equation with the drawback of energy conservation violation .', 'A major drawback of multipolar electrostatics is the increased computational cost .', 'Lattice QCD at finite density suffers from a severe sign problem , which has so far prohibited simulations of the cold and dense regime .', 'A major drawback of this procedure is that if N is the number of product vibrational modes , the amount of trajectories necessary to converge the calculations is ∼10(N) × larger than with the standard QCT method .', 'A major drawback of these pulses as theoretical prediction is concerned , however , results from their time-dependent offset : simulations of spin density matrices under the influence of a time-dependent Hamiltonian with non-commuting elements are costly in terms of computational time , rendering data analysis impracticable .', 'Specific absorption rate is a serious problem at high field strengths , especially for sequences involving many high power radiofrequency pulses , such as turbo spin echo ( TSE ) .', 'A major drawback of traditional AIMD methods is the necessity to enforce the orthogonalization of the wave functions , which can become the bottleneck for very large systems .', 'We note that these long-range correlations pose a serious problem if one wishes to obtain certain physical properties such as Kirkwood-Buff integrals from simulation results .', "We demonstrate that this QMC + machine learning approach works even for systems exhibiting a severe fermion sign problem where conventional approaches to extract information from the Green 's function , e.g. in the form of equal-time correlation functions , fail .", 'The failure of the time-dependent density-functional theory to describe long-range charge-transfer ( CT ) excitations correctly is a serious problem for calculations of electronic transitions in large systems , especially if they are composed of several weakly interacting units .']


Cluster  1028
['The corresponding drawback to such an approach is that its predictions are not validated on actual documents', 'One limitation of all these methods is that they are designed to find only full sentences', 'A drawback of this kind of sentence-based evaluation is the neglect of document structure', 'However , a more fundamental difficulty is that many of the textual characteristics which are problematic for a pipeline to generate are also difficult to measure computationally', 'Of course , a fundamental problem in evaluating NLG is that there may be many acceptable outputs', 'The latter drawback is the more serious one : the metrics were not designed to evaluate single key/response pairs , but whole texts', 'However , a limitation with most of these tools is that they suffer from lack of a comprehensive search facility .', 'A drawback of this approach , however , is that it may fail to detect relevant documents where no or only few words from a query are found .']


Cluster  430
['Over half of patients with unilateral cryptorchidism and the majority of patients with bilateral cryptorchidism display an abnormal spermiogram , which indicates that unilateral cryptorchidism is a bilateral disease ; therefore , it represents a serious andrological problem .', "I have an embarrassing problem . Over the past year or so , my erections seem to have become crooked . My sex life is fine , but I want to know if it 's a serious problem and if I should see a doctor .", 'This issue may be compensated by a scrotal skin flap , with the drawback of hair growth [ 1 ] .', 'Exogenous androgen supplement is an optional treatment for micropenis; however, its use in childhood is controversial due to potential side effects', 'Alprostadil is very well tolerated ; however , penile pain is a serious problem in a significant proportion of patients .', 'The age-related values of penile and testicular measurements must be known to be able to determine the abnormal sizes and to monitor treatment of underlying diseases.', 'Short term and local application of DHT at low doses in patients with micropenis could accelerate penile growth effectively without evident side effects; however, precautions still need be taken due to the paucity of long term study and the lack of ideal DHT dosage.', 'Loss of length in men with PD remains a serious concern .', 'The aim of this prospective study was to establish normal reference values for stretched penile length, penile circumference and testicular volume for Egyptian newborn and infants.']


Cluster  512
['The survey was conducted among 87 children (56 girls and 31 boys aged 7-13 years, mean age 10.', 'All 1,225 students attending the junior high schools in Sasayama City were invited to participate in this study.', 'In total, 196 students from five primary schools, randomly selected between 9 and 12 years (mean age: 10.', 'To compare the occurrence of cardiovascular risk factors in adolescents enrolled at public schools in the city of Rio de Janeiro, including a renowned school for sport practices.', 'A census type study was conducted with physical education teachers of the basic education network from Pelotas.', 'Cross-sectional study, convenience sampling of 422 students enrolled at the Experimental Olympic Gymnasium (EOG) and at Figueiredo Pimentel School (FP).', '102 samples were collected from subject of 18-26 years old, 60 (58.']


Cluster  1917
['A total of 3306 of the 72,221 participants (4.', 'A total of 317 students participated.', 'The 148 cadets enrolled for the study were allocated to two groups of 74 each.', 'There were 448,827 admissions, of which 350,648 (85.', 'There were 4993 encounters (4038 athletes, 955 non-athlete encounters).', 'We included 274 students enrolled at the EOG and 148 at FP.', "A total of 3623 admissions met the study's parameters."]


Cluster  1933
['In these patients , Gramnegative sepsis , the symptoms of which are predominantly caused by LPS-induced release of monokines , represents a serious problem .', 'We conducted a randomized, controlled trial using two previously validated models of sepsis in rats: 1) A fecal peritonitis model using a stent perforating the ascending colon, and 2) An endotoxemia model using lipopolysaccharide (LPS) toxin from E. coli.', 'Endotoxicity originating from a dangerous debris ( i.e. , lipopolysaccharide , LPS ) of Gram-negative bacteria is a challenging clinical problem , but no drugs or therapeutic strategies that can successfully address this issue have been identified yet .', 'Inflammatory shock as a consequence of LPS release remains a serious clinical concern .']


Cluster  1142
['For over 40 years , acid deposition has been recognized as a serious international environmental problem , but efforts to restore acidified streams and biota have had limited success .', 'Acid rain is a serious environmental problem in the world and is of a particular concern in southern China where most of the soils are acidic .', 'Until recently , acid deposition has been widely considered a serious ecological problem but not a threat to human health .', 'Acid deposition has been recognized as a serious environmental problem in China .', 'Acid rain pollution is a serious environmental problem in the world .', 'Acid rain : a serious regional environmental problem .', 'Acid rain is a serious global environmental problem .', 'As a result of emission reduction legislation , atmospheric acid deposition is currently on the retreat in the richer industrialized regions ( e.g. , Europe , U.S. , Japan ) ; however , because many other regions of the world are at present rapidly developing their polluting industries ( e.g. , China and India ) , " acid rain " will most probably remain a serious ecological problem on regional scales .']


Cluster  1173
['Such a severe complication of CCRT is a serious concern in esophageal cancer treatment .', 'Terminal surgical experiment and in vivo study.', 'This rapidly achieved endoscopic palliation represents a major advance in the management of a serious medical problem .', 'A major drawback of laser endoscopy in the palliation of malignant dysphagia is the need for repeated treatments .', 'The complication of TEF secondary to malignancy is a devastating problem that carries a bleak prognosis , but when it is performed promptly after the diagnosis of a malignant TEF , esophageal bypass or stenting improves survival and quality of life for these unfortunate patients .', 'However , there is a serious problem in patients with gastric cancer after CABG with RGEA graft .', 'Especially patients been operated for head and neck cancer can be a serious problem for the removal of percutaneous endoscopic gastrostomy .']


Cluster  1929
['22 noncirrhotic and 11 cirrhotic patients undergoing liver resection were enrolled.', 'The aim of this trial was to compare the efficacy and safety of BiClamp forceps with the "gold-standard" clamp-crushing technique for open liver resection.', 'Laparoscopic surgery and robotic surgery have solved the issue of large incisions , which used to be a major drawback of open liver surgery ; however , further improvements are required in order to achieve the level of safety and accuracy observed during open liver resection when performing all minimally invasive procedures .', 'PHLF remains a serious problem in patients undergoing major liver resection .', 'The aim of this study was to describe and compare the perioperative and postoperative morbidity and mortality associated with PoPH and PVH in patients undergoing liver transplantation.', 'Patients with liver lesions that required a resection were eligible.', 'But despite advances in diagnostic , imaging and surgical techniques , postoperative liver dysfunction of varied severity including death due to liver failure is still a serious problem in such patients .', 'Liver regeneration after an extensive liver resection is a serious clinical problem , which is difficult to study in detail on patients .', 'The use of energy devices combined with crush clamping reduced blood loss during liver transection.', 'Control of blood loss is a serious problem during liver resection .']


Cluster  928
['The complications of this method cause to a serious concern .', 'Although technique is simple and effective , a drawback of this surgical procedure is its potential to cause minor but some times permanent alteration in rectal continence .', 'The problem with the standard methods of incision closure is that they will often result in noticeable blunting of the alar crease .', 'A major drawback of the procedure relates to the need to perform surgery and assign risk to an otherwise healthy individual .', 'A drawback of this approach is that removal of the lesion leaves a void that may cause a visible deformity and adversely affect long-term function .', 'However , the necessity for a medial malleolar osteotomy is the major drawback of the technique .', 'One problem with this method is that the lesion can not always be maintained in the center of the cap because the procedure is performed blindly after aspiration .', 'A possible drawback of this operation is the difficult access to the excluded proximal intestinal tract and , consequently , to the biliary tract .', 'A drawback of this technique is the possible instability of the anterior chamber caused by the sudden exit of air when the dye is injected with the cannula through the side-port incision .', 'However , the benefit of small incisions has a drawback of limited visualization of subsurface tissues , which can lead to navigational challenges in the delivering of therapy .', 'This is a highly invasive procedure with a risk of developing potentially serious complications in addition to its drawback of exposure to ionizing radiation .', 'In none of the patients CT guided drainage of collections was performed prior to surgery , which was a major drawback of the treatment .', 'However , a narrow corridor to the lesion is the drawback of this approach .', 'The problem faced with this technique is that the traction sutures cut through the tissues leading to re-operations .', 'However , a notable problem of EMR for SDET is technical difficulty for the lesion with non-lifting sign , and it of UEMR is that en bloc resection rate is relatively low .', 'However , the increased radiation exposure potentially associated with transradial access is a possible drawback of this method .']


Cluster  1426
['Our aim was to investigate the long-term efficacy and safety of canagliflozin, a sodium-glucose co-transporter 2 inhibitor, added to background sulfonylurea (SU) monotherapy for patients with type 2 diabetes mellitus.', 'There was a significant decrease in body weight, BMI, waist circumference, total body fat and serum glucose levels in the metformin group (p<0.', 'Metformin can lead to weight loss gradually in newly-diagnosed type 2 diabetes patients.', 'Saxagliptin significantly improved glycemic control and was well tolerated in Chinese T2DM patients, including the elderly and patients with mild renal impairment.', 'The glucagon receptor antagonist PF-06291874 has demonstrated robust glucose reductions in subjects with type 2 diabetes mellitus (T2DM) on background metformin.', 'We aimed to find out the possible predictive factors of weight change induced by metformin based on an analysis of a phase IV open-labeled trial.']


Cluster  465
['Vitamin A deficiency ( VAD ) is a serious and widespread public health problem in developing countries .', 'Dietary vitamin B12 deficiency is a severe problem in the Indian subcontinent , Mexico , Central and South America , and selected areas in Africa .', 'In Peru , Honduras , Argentina , Ecuador , and Brazil , vitamin A deficiency is a moderate public health problem ( prevalence from 14.0 % to 17.4 % ) , while in Colombia , Mexico , and Haiti it is a severe public health problem ( prevalence from 24.3 % to 32.0 % ) .', 'In sub-Saharan Africa , vitamin A deficiency constitutes a severe health problem despite various supplementation and food fortification programs .', 'Vitamin A deficiency : a serious nutritional problem in many areas of the world today .', 'Vitamin A ( VA ) deficiency is a serious public health problem , especially in preschool children who are at risk of increased mortality .', 'Vitamin A deficiency is still a serious public health problem affecting an estimated 127 million preschool children .', 'Mild or marginal vitamin A deficiency ( MVAD ) is still a serious and widespread public health problem in pregnant women and children in developing countries .', 'Among 8 studies on subclinical vitamin A deficiency , 7 of them indicated a severe public health problem ( > 20 % ) .', 'Nutritional vitamin B₁₂ deficiency due to maternal deficiency might be a serious health problem in infants .', 'Vitamin A deficiency was still a serious health problem in children in China cities .', 'Among mothers , 27 % had chronic energy deficiency ( body mass index , < 18.5 kg/m(2 ) ) and 20 % were night blind , indicating that vitamin A deficiency was a serious problem .', 'Vitamin A combined with vitamin B can effectively prevent anemia in premature infants, which has important clinical significance.', "Xerophthalmia prevalence ranged from 1.6 % to 4.4 % for nightblindness and 0.6 % to 2.7 % for Bilot 's spots in the three provinces indicating a serious vitamin A deficiency problem .", 'Xerophthalmia due to vitamin A deficiency is a leading cause of blindness in children and has been a serious problem in Indonesia .', 'Vitamin A deficiency ( VAD ) is a serious and widespread public health problem and the leading cause of preventable blindness in young children .', 'According to international criteria , the national prevalence of marginal vitamin A status found in the survey identifies the country as having a serious public health problem of vitamin A deficiency .', 'A potential problem with plant-based diets is that they lack key micronutrients , such as vitamin B']


Cluster  1482
['Existing diagnostic criteria such as revised El Escorial criteria ( R-EEC ) and Awaji algorithm have a drawback of low sensitivity .', 'For both passive and active head shaking, using presence/absence of vertigo and of nystagmus, sensitivity was low (<0.', 'Jolt accentuation itself has a limited value in the diagnosis of meningitis regardless of altered mental status.', 'Unfortunately , low sensitivity is a serious concern .', 'Among 118 patients, the sensitivity and specificity of jolt accentuation in the broad sense were 70.']


Cluster  2127
['Although atrial fibrillation ( AF ) is the most commonly occurring arrhythmia in the general population and is a serious health problem , its incidence in patients on hemodialysis is unknown .', 'This cluster randomized trial will examine the effect of using a smartphone-based application such as FibriCheck® on the detection rate of atrial fibrillation in a Flemish general practice population.', 'Forty-two patients with atrial fibrillation (average age: 69.', 'Stroke is a serious clinical problem and atrial fibrillation is associated with it .', 'Twenty-three patients with atrial fibrillation were investigated using overnight polysomnography, including esophagus pressure monitoring and ECG, before and after the cardioversion of persistent atrial fibrillation.', 'The purpose of this study is to determine the number of symptom clusters present among adults with chronic atrial fibrillation and to explore sociodemographic and clinical factors potentially associated with cluster membership.', 'Atrial fibrillation ( AF ) is the most common arrhythmia and has become a serious public health problem .']


Cluster  1517
['Chlamydial disease in adolescent women is a serious public health problem , but secondary preventive efforts through early detection and treatment are encumbered by the cost and complexity of mass screening .', 'Avian chlamydiosis ( AC ) can be economically devastating to producers and a serious public health problem .', 'Chlamydia trachomatis infection is a serious public health concern that disproportionately affects adolescent girls .', 'Mature eggs develop into hydatid cysts in different organs , leading to hydatid disease , which is a serious public health problem .', 'Genital chlamydial infection , with its possible long-term morbidity , is a serious public health problem .', 'Sexually transmitted Chlamydia trachomatis infections are a serious public-health problem .']


Cluster  643
['Serum CysC, at the time of CRRT cessation, is an independent predictor of the successful weaning from CRRT in critically ill patients with acute kidney injury.', 'Chronic renal failure is a serious health problem in the United States and other developed countries , and large amounts of public funds are being expended for what is essentially palliative treatment of this disease .', 'the cost of chronic kidney disease requires a large amount of economic resources , and is becoming a serious problem for health services and families .', 'To retard progression of chronic kidney disease (CKD) and reduce end-stage kidney disease, it is important to detect acute kidney function worsening on CKD (AW-CKD) immediately and bring back their kidney functions to baselines by appropriate treatment', 'Renal insufficiency is a serious medical and public health problem worldwide .', 'Continuous renal replacement therapy (CRRT) is a treatment for acute kidney injury (AKI) patients.', 'Chronic renal failure , particularly end-stage renal disease , is a serious health problem associated with a high mortality rate .', 'Chronic renal failure is a devastating medical , social , and economic problem for patients and their families in India and Pakistan .', 'Acute renal failure ( ARF ) remains a serious medical problem with a high mortality rate .', 'Chronic renal failure ( CRF ) represents a serious medical problem .', 'Micronutrient depletion is a major drawback of high-dose continuous renal replacement therapy ( CRRT ) .', 'Acute renal failure presents a serious and life-threatening problem in hospitalized patients .']


Cluster  1154
['These data confirm a possible association between some ambient air pollutants and CVD events, precisely MI and IS, with different temporal and cumulative effect.', 'Accelerating prevalence of coal workers pneumoconiosis is considered as a serious occupational health problem .', 'Ambient air pollution and respiratory bacterial infections , a troubling association : epidemiology , underlying mechanisms , and future challenges .', "Air pollution is an important risk modifiable factor for dementia across the world , and the recent report of the Alzheimer 's disease continuum in children and young adults residing in Metropolitan Mexico City along with the presence of cognitive impairment in 55 % of the young adult population residing in Mexican cities with fine particulate matter concentrations above the current USEPA annual standard of 12 μg/m3 makes this a severe public health problem in progress .", 'Air pollution is a serious environmental health problem that has been previously associated with neuropathological disorders .', 'This review presents some available data on the PFAS environmental distribution in the world , and in particular in Europe and in the Veneto region of Italy , where it has become a serious problem for human health .', 'Air pollution is a serious public health concern worldwide , and cumulative evidence has revealed that air pollutants contribute to epigenetic variation in several genes , and this in turn can contribute to disease susceptibility .', 'Human exposure potential to PBDEs from automobile dust ingestion remains a serious concern in the U.S. population .']


Cluster  2109
['Non-small cell lung cancer (NSCLC) remains the leading cause of cancer death worldwide, although important advances in target therapy have been developed in the past few years', 'Lung cancer is a serious public health problem and Non Small Cell Lung Carcinoma , NSCLC , is particularly resistant to current treatments .', 'Non-small cell lung cancer ( NSCLC ) is a serious health problem .', 'Non-small cell lung cancer ( NSCLC ) has become a serious global health problem in the 21st century , and tumor proliferation and metastasis are the leading causes of death in patients with lung cancer .']


Cluster  40
['Excess use of pesticides through chemical disease control measures is a serious problem for sustainable agriculture as we struggle for higher crop productivity .', 'Haphazard use of pesticides in the field and stored food commodities for the control of insect and pest has been a serious problem from view of environment and public health .', 'SIGNIFICANCE : Pesticide resistance is a serious problem that hampers the successful production of crops .', 'Contamination of the land and water by neonicotinoid insecticide residues is currently a severe environmental problem .', 'Human poisoning by pesticides has long been seen as a severe public health problem .', 'In addition to water contamination , the presence of pesticide residues in food poses a risk to the population , being a serious public health problem in Brazil .', 'In recent years , water pollution and pesticide accumulation in the food chain have become a serious environmental and health hazard problem .', 'The excessive use of pesticides is a serious health problem due to their toxicity and bioaccumulation through the food chain .', 'Pesticide residue in vegetables is a serious problem that has adverse effects on human health .', 'Pesticide contamination in Tajikistan is a serious and ongoing problem that requires the attention of local , state governments , and international non-governmental organizations .', 'The indiscriminate use of pesticides has been contributing for the environmental quality degradation , as well as it increases the occupational exposures to these products , determining a serious public health problem in rural areas .', 'In China , water pollution by pesticide mixtures has constituted a serious environmental problem due to potential toxicity and bioaccumulation .', 'Pesticide residues in the food above the maximum permissible residual limit ( MRL ) for safe consumption are a severe concern today .', 'Global pollution from excessive pesticide use has become a serious environmental and public health problem .', 'Old , obsolete pesticide stocks are a vexing problem in numerous developing countries .', 'The presence of pesticide residues in fruit is a serious health concern .', 'Exposure to pesticides has become a serious concern for the environment and human health .', 'The indiscriminate use of pesticides has become a serious environmental concern .', 'Since the beginning of the widespread use of pesticides , their removal from food has become a serious concern .', 'However , the pesticide levels found can not be considered a serious health problem according to results from other pesticide monitoring studies .', 'This results show that the detected pesticides could not be considered a serious public health problem .', 'Comparison of the daily intake peak ( DIP ) and daily intake mean ( DIM ) relative to the acceptable daily intake ( ADI ) shows that groundwater contamination with pesticides is a serious problem .', 'Pesticide drift is a serious environmental and safety concern that affects all of US agriculture .', 'The results indicate that the occurrence of pesticide residues in apples could not be considered a serious public health problem .', 'Intensive use of pesticides , especially insecticides , in agriculture during the past several decades has already led to contamination of surface and underground waters and sediments in some regions , thus presents a serious problem for the environment .', 'The use of pesticides on cash crops and exportable food commodities had always been a serious concern .', 'Pesticide contamination in the rice fields has manifested into a serious global environmental concern .', 'Pesticide poisonings in children continue to be a serious problem .']


Cluster  30
['Oculomycosis is a severe problem in most developing countries .', 'Thus , clonorchiasis has become a serious public health problem in Guangdong province .', 'Suppurative corneal ulcers due to filamentous fungi are a serious and intractable problem in many tropical developing countries .', 'Suppurative keratitis is a serious problem in all tropical countries , but very little information is available about the causative organisms in Africa .', 'Ophthalmomyiasis may not be a serious public health problem in Oman , but a nationwide survey of all myiases may be worthwhile .', 'The current epidemiological and clinical statuses of amebiasis make it a serious public health problem worldwide .', 'Fungal keratitis is a serious problem affecting the agrarian poor and hence requires attention from public health specialists .', 'The prevalence of scabies is high in children in the displacement camps , suggesting that it may be a serious public health problem not only in these camps , but also in the entire country .', 'In the late 1960s , the management of fungal keratitis was a serious unresolved problem .', 'In Morocco , neurosyphilis is a serious public health problem .', 'Tungiasis is a serious problem of Public Health in many countries of Latin America and Subsaharian Africa , and it can be considered in these localities as an indicator of underdevelopment and poor hygiene conditions .']


Cluster  1451
['Lichen sclerosus (LS) is a difficult to treat, often relapsing disease with unknown background.', 'Based on our results, we assume that PDT may influence the immune status of patients with Lichen sclerosus.', 'Lichen planus (LP) is a moderately prevalent inflammatory disorder that affects the skin and the oral mucosa, leading to a characteristic appearance and causing severe itching.']


Cluster  2098
['The text analysis component constructs and traverses the information of these layers under control of the discourse development . in the approximation of exponentially many parse trees by a polynomial-size sample', 'The text analysis component constructs and traverses the information of these layers under control of the discourse development . in the approximation of exponentially many parse trees by a polynomial-size sample', 'The text analysis component constructs and traverses the information of these layers under control of the discourse development . in the approximation of exponentially many parse trees by a polynomial-size sample']


Cluster  864
['To determine the prevalence of HIV, Treponema pallidum and hepatitis B Virus (HBV) in male inmates at the Preventive Detention Center (CDP) of Arica.', 'Low rates of participation constitute a serious problem for family-based drug-use prevention programs .', 'The problem with this is that many of these " symptoms " of drug use are , in the case of SNAP participants , tied to contextual issues of living in the DTES , experiencing structural vulnerability , and being the target of punitive drug policies and laws .', "We use data from the Fragile Families and Child Wellbeing Study , augmented with information from hospital medical records , to estimate the effects of the birth of a child with a severe health problem on the likelihood that the infant 's father engages in illegal activities .", 'The mass incarceration of pregnant and parenting women is a serious problem in U.S. A policy focus is needed that takes a public health approach .', 'Low participation rates constitute a serious problem faced by family drug abuse prevention programs .', 'CJ-DATS applies implementation science perspectives and methods to address a vexing problem - the need to link offender populations with effective treatment for drug abuse , HIV , and other related conditions for which they are at high risk .', 'The study reasserts the predisposing factors for the transmission of STDs as age, early sexual debut, drug abuse and overcrowding, noting that prisons are highly vulnerable environments where overcrowding, sexual condition, early sexual initiation, high drug abuse and the lacking spouses visits provide an epidemiological context favorable for increased STD.']


Cluster  1921
['It has appeared under a number of names : success -LRB- Yang et al. , 2006 -RRB- , accuracy -LRB- Kehler et al. , 2004a ; Angheluta et al. , 2004 -RRB- and success rate -LRB- Tetreault , 2001 -RRB- . taking into consideration only one-word terms', 'It has appeared under a number of names : success -LRB- Yang et al. , 2006 -RRB- , accuracy -LRB- Kehler et al. , 2004a ; Angheluta et al. , 2004 -RRB- and success rate -LRB- Tetreault , 2001 -RRB- . taking into consideration only one-word terms']


Cluster  967
['Triage in civilian practice first became a serious issue with the development of dialysis for chronic renal failure in the 1960s and the problem of the allocation of this scarce and very expensive treatment .', "Degradation of dialysis efficiency during hemodialysis , caused by incompatible indwelling needle size or increase in hematocrit , is a serious problem that can threaten a patient 's life .", 'Vascular access thrombosis represents a serious problem in haemodialysis patients .', '[ Hemodialysis as a heavy burden on the health insurance system . A serious problem to smaller insurance groups ] .', 'Microcirculatory dysfunction is noted in dialysis patients, and this alteration is ameliorated in KT recipients.', 'Vascular access thrombosis represents a serious and common problem in hemodialysis patients .', 'Vascular access dysfunction is a serious problem in dialysis units .', 'The occurrence of thrombosis in the vascular access is a serious problem that may severely compromise or even make the hemodialysis impossible , which is vital for the patient .', 'This can cause hypovolemia-induced hypotension , a serious problem in the daily practice of hemodialysis : during one out of three sessions a hypotensive episode occurs .', 'Cardiovascular mortality in dialysis patients remains a serious problem .']


Cluster  511
['The MASS scores were significantly higher during MA and VA compared with SA at both LI4 and LI10 (p<0.', '30 young healthy volunteers (21 men and 9 women) received VA, MA, and SA at LI4 and LI10 in a randomised, single-blind, placebo-controlled, cross-over manner.', 'The SB CPET resulted in lower peak VO2 (2806±652ml·min(-1) (SB) vs 3329±798ml·min(-1) (UB) and 3550±799ml·min(-1) (TM); p<0.', 'Serum CRP and SAA reflected the recovery process well and therefore may be used as markers of treatment response.', 'The experimental treatment resulted in higher improvement on the FMA-UE compared with CG (P= 0.', 'The progressive reduction in the clinical scores was correlated with the improvement of the RCM parameters.', 'The LMA group had a significantly lower percentage of desaturation (pulse oximetry saturation [SpO2] <88%) events compared to the non-LMA (NLMA) group (37 vs.', 'The VASOF results in the pre-emptive group were significantly lower compared to the preventive group at 4, 8, 12, and 24 h (0.', 'After APT, trained group presented an increase in VO2 relative to LBM (P=0.', 'The UltraTENS and PhP groups experienced considerable improvement in both VAS and total WOMAC scores post-treatment (P< 0.', 'After treatment a significant improvement of each parameter of VHI has been demonstrated.', 'It was observed a faster recovery until the 3rd POD in the IC and PEF variables in the NIV group; in addition, there were fewer complications in this group.', 'The data demonstrated that the minimal values of HR, SBP, and DBP as well as MABP decreased significantly during operation comparing with the corresponding values before operation (p\xa0<\xa00.', 'Both VAS and NDI were significantly reduced post-treatment for all treatment groups.', 'Abnormal functional capacity was indicated by ROC result of mPAP cut-off value of >\u200924\xa0mmHg (p\u2009=\xa00.', 'The evaluation of the response to treatment was also measured through the use of photographic documentation and examination by reflectance confocal microscopy (RCM) performed at baseline and after therapy.']


Cluster  167
['This study investigates electronic monitoring device performance and acceptability in children using quantitative and qualitative measures.', 'To determine the prevalence of musculoskeletal disorders (MSD) and depression as well as the correlation between them, if any, among kindergarten workers.', 'This study aimed at evaluating the program regarding 1)\xa0the effects on parental health knowledge and parental satisfaction with routine child health checkups, 2)\xa0the sensitivity of the effects on SES, and 3)\xa0parental acceptance of the written educational material.', 'This article introduces the protocol of a study aiming to evaluate the effectiveness of digital WellWe intervention in supporting the participation of families with small children in the promotion of their health.', "To ascertain the impact of ludic workshops on children's knowledge, self-care, and body weight.", 'Furthermore , childhood-onset lupus patients may experience a serious negative impact on their psychosocial and physical development , issues that pose extra challenges to healthcare providers .', 'Because the problem of childhood underimmunization continues to be a serious concern for specific populations , it is essential that mothers have access to information that is concise , user friendly , and written at their level of understanding .', 'The results from this study will make it possible to determine whether this new method can be recommended for implementation in child health clinic settings to support the participation of families with small children in promoting their health.', 'This study examined the efficacy of Triple P Online - Disability (TPOL-D) a telehealth intervention for parents of children with a disability.']


Cluster  1567
['A total of 418 patients were identified during the study time frame.', '162 patients were enrolled in the study; 142 were included in the intention-to-treat analysis (53.', 'A total of 726 patients were included in the analysis; of these, 39 (5.', '518 patients were included.', '118 patients were enrolled; 37 patients (31.', 'A total of 72 patients were enrolled at a single public hospital.', 'Of the 110 patients evaluated, 89 (80.', 'In total, 634 patients were included.', '95 patients were included for analysis, 44.', 'Of the 183 patients included in NOR-SASS, a total of 83 (45.', 'Out of 1486 patients, 77 died (5.', 'A Total of 385 patients were enrolled into the study; 80.', 'Of the 303 included patients, 216 (71.', 'A total of 66 patients were included (37.']


Cluster  189
['This prospective cohort study enrolled 56 adult patients: (1) for whom no conclusive diagnosis could be reached noninvasively; (2a) who had lesions involving deep-seated and eloquent areas, multifocal lesions, or lesions for which craniotomy and lesion removal was not indicated, or (2b) were poor candidates for craniotomy (> 80 years of age and/or with serious comorbidities).', 'An open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations.', 'Tympanic membrane perforations were predominantly subtotal (p = 0.', "Temporal fossa hollowing can represent a serious cosmetic concern to patients ' , whether congenital ; part of a post-traumatic deformity ; following oncological resection ; or following orbital decompression procedures .", 'We propose that speech and language problems in adults undergoing surgery in the posterior fossa occur more frequently than previously assumed.', 'Facial paralysis remains a vexing problem in the treatment of posterior cranial fossa tumors in children .', 'Through a prospective single-center study, data on 59 tumor operations in the posterior fossa were collected preoperatively as well as 1 week and 1 month postoperatively.']


Cluster  236
['The study enrolled 39 young women and 18 young men receiving bromocriptine treatment.', 'Ethical approval for the study was obtained from the Singhealth Centralised Institutional Review Board (CIRB Ref: 2017/2710).', 'A controlled, randomized, blinded clinical assay was performed.', 'This study is innovative since there is little evidence from clinical trials in adolescents and young adults; similar studies are not known in our context.', 'Cabergoline is superior to bromocriptine in affecting male and female sexual functioning and should be preferred in hyperprolactinemic men and women with sexual dysfunction.', 'Young males were randomized (double blind) to Cr (N.', 'Further studies are needed to evaluate whether the results of the present study can be generalized to clinical samples.', '14 subjects were enrolled in this study using EndyMed PRO<sup>™</sup> platform.', 'Institutional ethical approval and study approval were obtained.', 'If RH-PAT is used in research or as a clinical tool in adolescents, the shown age- and sex-dependence of RHI have to be taken in account.', 'The study was conducted in an in vitro and in vivo phase.']


Cluster  527
['Sinupret extract can safely be administered in patients with CRS.', 'These findings suggest that doxycycline may have a beneficial role for CRSwNP patients, especially for patients without asthma, NERD or high levels of serum IgE before treatment.', 'Recently, we described an inverse association between cranberry supplementation and serum prostate specific antigen (PSA) in patients with negative biopsy for prostate cancer (PCa) and chronic nonbacterial prostatitis.', '929 patients suffering from CRS were enrolled in this randomised placebo-controlled trial with a treatment period of 12 weeks.', 'The results of our trial will establish evidence for the efficacy of infrared laser moxibustion for CRF, a very common and challenging symptom.', 'This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery.', 'Cranberry concentrate does not seem to effectively prevent UTIs in female patients with hip fracture and indwelling urinary catheter.', 'We could not show significant difference of effect between fluticasone propionate and clarithromycin in the post-operative treatment for CRSsNP and eosinophilic and non-eosinophilic CRSwNP patients.']


Cluster  1690
['Momordica charantia supplementation offers a safe alternative to reducing pain and improving symptoms among the primary knee osteoarthritis patients while reducing the need for analgesia consumption.', 'For most complementary and alternative medicine interventions , the absence of a high-quality evidence base to define good practice presents a serious problem for clinicians , educators , and researchers .', 'Ayurveda research publications : A serious concern .', 'Self-massage of the knee with ginger oil may be used as a complementary method to standard medical treatment.', 'Patients treated with chamomile showed significant improvements after 4 weeks for pain (P < 0.', 'The US National Center for Complementary and Alternative Medicine ( CAM ) defines CAM as " a group of diverse medical and health care systems , practices , and products that are not presently considered to be part of conventional medicine . " The problem with said therapies is that , for the most part , their effectiveness is questionable and their side effect profile is essentially unknown .']


Cluster  1358
['Decreased serum zinc levels are associated with high mortality, accompanied by impaired exercise capacity.', 'Zinc deficiency remains a serious health problem worldwide affecting developed as well as developing countries .', 'Zn deficiency in human is one of the major causes of hidden hunger , a serious health problem observed in many developing countries .', 'Because of its low availability in arable soils worldwide , Zn deficiency is becoming a serious agricultural problem resulting in decreases of crop yield and nutritional quality .', 'Zinc deficiency in rice is a serious problem .', 'Zinc deficiency in humans is a serious problem worldwide with an estimated one third of populations at risk for insufficient zinc in diet , which leads to impairment of cognitive abilities and immune system function .', 'Supplementation of chelated zinc plus multivitamins for 6 months significantly increased height gain in Thai schoolchildren and was well tolerated.', 'Zinc is an essential trace element for growth and development in children , but zinc deficiency is a serious nutritional problem worldwide .']


Cluster  1239
['The three modalities of treatments proved to be effective clinically and histopathologically in treating both types of striae, which were well tolerated by the patients with minimal, transient side effects and our study results gave us guidelines for their clinical application.', 'This study included 20 patients with striae alba.', 'There was a significant improvement in striae alba in both groups after than before treatment.', 'Forty-five female patients with striae distensae were randomly selected from the outpatient dermatology clinics of Al-Zahra university Hospital within 6 months period.', 'measure and compare between efficacy and tolerability of three modalities for treatment of striae distensae.']


Cluster  1793
['Biodiversity and evolution of circulating bacteria and virus populations is a serious scientific problem , solving this problem is necessary for effective prophylaxis of infectious diseases .', 'Arboviruses , arthropod-borneviruses , are frequency associated to human outbreak and represent a serious health problem .', 'Clonal recycling of hybrid El Tor with increasing virulence in a changing climate and in a region with a growing urban population represents a serious public health concern for Bangladesh .', 'After the eradication of smallpox , human monkeypox constitutes the most important orthopoxvirus infection in man , but analysis of information collected up to this time suggests that it does not represent currently a serious public health problem or a challenge to the achieved eradication of smallpox .', 'The Evidence possibly supporting or disputing this hypothesis is reviewed , however the major problem with the hypothesis is that to date no coronavirus has ever been isolated from arthropods .', 'The study concluded that the circulating El Tor variant strains of epidemic potential in the region can be a serious concern in the future .', 'Species tropism constitutes a serious problem for developing relevant animal models of infection .', 'In the scenario of global warming and climate change , an outbreak of new pests and pathogens has become a serious concern owing to the rapid emergence of arms races , their epidemic infection , and the ability to break down host resistance ,']


Cluster  311
['Music performance anxiety ( MPA ) , or stage fright in music performance , is a serious problem for many musicians , because performance impairment accompanied by MPA can threaten their career .', 'This study aimed to compare the effects of swinging and playing of white noise on the crying and sleeping durations of colicky babies.', 'Playing of white noise significantly decreased the daily crying durations (p\xa0<\xa0.', 'Though this pilot study had high levels of attrition, the results do suggest that regular listening to relaxing music should be explored further as an effective non-pharmacological means for reducing prenatal anxiety and depression.', 'Home systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the music listening group were significantly reduced compared with baseline (-9.', 'The music group demonstrated lower Trait Anxiety (p\xa0=\xa0.', 'Sixty healthy women (Mage\u200a=\u200a25 years) were randomly allocated to 3 different conditions (listening to water sounds, a relaxing piece of music, or no auditory stimulus: n\u200a=\u200a20 per condition) for 10 minutes before they were exposed to a standardized psychosocial stress task.', 'These pilot results suggest that music listening may be an effective tool for reducing anxiety among older adults in the ED.', 'Pregnant women were recruited online and randomly assigned to one of two groups: the music group (daily listening to specially composed songs) or control group (daily relaxation) for 12\xa0weeks each.', 'The strip charts showed a significantly increased basal fetal heart rate and higher fetal reactivity, with accelerations of fetal heart rate in pregnant women with music stimulation.']


Cluster  689
['Metastatic lesions within the ovary constitute a serious diagnostic problem in daily practice .', 'We performed a retrospective review of patients with stage I uterine adenosarcoma diagnosed and treated at a single institute from 1998 through 2014.', 'Endometrial cancer remains , today , a serious problem , especially for postmenopausal women .', 'It is also a serious problem for endometrial cancer ( EC ) study .', 'The massive ovarian cyst ( greater than 25 pounds ) presents a challenging opportunity for surgical intervention and potential cure of a debilitating problem .', 'The RDW is associated with ovarian cancer and is a potential marker of its progression.', 'To analyze the stage-specific percentage of pelvic and para-aortic lymph node metastases and the upstaging ratio in a prospective randomized trial (Uterus-11).', 'Ovarian cancer ( OC ) is a serious public health concern in the world .', 'Ovarian cancer is a life-threatening diagnosis which poses multiple challenges .', 'Pelvic US remains the workhorse for detection and characterization of adnexal masses in most centers worldwide', 'Malignant tumors of the female reproductive system are a serious health and social problem , as they are the second most common cause of death among women , after breast cancer .', 'Ovary cancer is a disease charged of paradigms and a serious health problem .', 'Nevertheless , since development of ovarian carcinoma in infertile women during infertility treatment is a serious concern for gynecologists , this review also covers important points for clinical practice , especially the issue of early detection of ovarian carcinoma .']


Cluster  1175
['Resuscitation training improved the knowledge of HCWs.', 'Implementation of ESC guidelines by nurses , the majority responders in this survey , is a serious problem , requiring urgent improvement to ensure patients receive optimal evidence based care .', 'A total of 293 HCWs completed the course (81 doctors and 212 nurse/midwives), with variable improvements of mean posttraining marks over the pretraining scores.', 'To examine the effectiveness of a clinical training protocol for clinicians to do EMR, as measured by clinician adherence.', 'This study aimed to determine the effect of customized training versus standard readily available training on surgical safety checklist (SSCL) compliance and comprehension.', 'A key task of emergency medicine (EM) training programs is to develop a consistent knowledge of core content in recruits with heterogeneous training backgrounds', 'This pilot study examined the effectiveness of the Virtual Electrosurgery Skill Trainer (VEST) on OR fire safety skills among prelicensure nursing students.', 'We prospectively evaluated compliance and comprehension of a locally modified SSCL among surgeons, anesthesiologists, nurses, and perfusionists who were randomized to standard versus customized training in the department of cardiac and thoracic surgery.', 'Prelicensure nursing students seeking to enter perioperative nursing need preparatory fire safety knowledge and skills training to participate as a member of an operating room (OR) team.']


Cluster  1351
['The classically used nontargeted chemotherapeutic approach to pancreatic cancer has a dual drawback of suboptimal drug delivery at the target site and the systemic side effects produced by the unfettered exposure of the drug to healthy tissue .', 'Twenty-five patients with advanced cancer pancreas progressed or failed on 1st line treatments and justified the inclusion criteria were eligible to receive Docetaxel 75\xa0mg/m<sup>2</sup> over 1h iv infusion on day 1, Oxaliplatin 80\xa0mg/m<sup>2</sup> over 2\xa0h iv infusion on day 2, the cycle was repeated every 3 weeks for 6-8 cycles unless disease progression or severe toxicity appeared.', 'Radiotherapy is emerging as an important modality for the local control of pancreatic cancer , but pancreatic cancer cell radioresistance remains a serious concern .', 'Pancreatic ductal adenocarcinoma ( PDAC ) is a deadly disease and a major health problem in the United States .', 'The major problem with using radiation to approximate surgery in unresectable disease is that the radiation dose required to ablate pancreatic cancer exceeds the tolerance of the nearby duodenum .', 'Pancreatic cancer remains a devastating problem with the majority of patients succumbing to death from this disease .', 'Pancreatic cancer represents a systemic disease, and its treatment ideally includes the administration of systemic therapy regardless of its anatomical stage', 'Pancreatic cancer (PC) remains difficult to treat, despite the recent advances in various anticancer therapies', 'Pancreatic ductal adenocarcinoma ( PDAC ) is a devastating disease with few therapeutic options , representing one of the great challenges in oncology .', 'Pancreatic cancer still represents a serious medical concern for which no adequate solution has thus far been found .', 'Pancreatic ductal adenocarcinoma is a devastating disease that represents an important health problem .', 'Pancreatic cancer is the deadliest of the 21 most common cancers, largely because it is often identified at a late stage, we aimed to determine the control rates, and PFS for patients who received docetaxel-oxaliplatin regimen as a 2nd line therapy.']


Cluster  1298
['We found that 86.7 % of students regarded frequent hand washing as the most important means of protection against COVID-19 , and 19.3 % of students did not regard the COVID-19 pandemic as a severe public health problem for Turkey at that moment .', 'After the application of the IoT management system, the hand hygiene compliance rates among the members of the medical staff before (29.', 'The aim of this study was to compare the effects of a fluorescent concretization intervention and conventional education on improving the hand hygiene beliefs and skills of nursing students.', "To observe student nurses' overall and moment-specific hand hygiene compliance during clinical placement.", 'The objectives of this study are to examine hand hygiene knowledge, beliefs, practices, perceived importance and behaviors using Social Cognitive Theory and simulation-based intervention.', 'The poor adherence to hand hygiene precautions in the operating room is a serious problem for patient safety and further studies should focus on resolving this problem .', 'There was a significant difference between the intervention and control groups in terms of the total post-test hand hygiene belief score (p\xa0=\xa0.']


Cluster  170
['L. gasseri OLL2716 has beneficial effects on FD without H. pylori involvement.', 'Recently , the acquisition by Helicobacter pylori of resistance to antibiotics has become a serious problem .', 'After the eradication of Helicobacter pylori infection , relapse is a serious problem in Turkey .', 'Modern triple drug regimens are highly effective for treating Helicobacter pylori infection , but bacterial resistance to one of the most effective antibiotics , metronidazole , is a serious and increasing problem .', 'Increasing resistance to drugs represents a serious problem in treatment of infections with Helicobacter pylori , providing cause of frequent therapeutic failures .', 'H. pylori infection is a serious public health problem , and thus the presence of H. pylori infection justifies treatment .', 'The link between H. pylori and , ulceration as well as its association with the development of both gastric cancer and mucosa-associated lymphoid tissue lymphoma in humans is a serious public health concern .', 'Helicobacter pylori is a cause of chronic gastritis , peptic ulcer disease , and gastric malignancy , infection being a serious health problem in Thailand .', 'Clarithromycin resistance of Helicobacter pylori is a serious problem in eradication therapy .', 'Although modern triple-drug regimens are usually highly effective in the treatment of H. pylori infection , the emergence of resistance to two of the most used antibiotics , metronidazole ( Mtz ) and clarithromycin ( Cla ) , is a serious and increasing problem .']


Cluster  417
['Although our series comprised a limited number of cases and a short follow-up period, initial results suggested that arthrocentesis with SH injection seemed to be superior to art.', "'Atypical' pattern was present in 63% (39/62) of patients with articular manifestations, of which arthralgia was a common manifestation (57%).", "To evaluate the effectiveness of therapeutic ultrasound with or without spica splint in the management of De Quervain's disease (DQD).", "Dupuytren's disease as a\xa0benign fibroproliferative disease leads to hyperplasia of the collagen fibers of the fascia of the palm, which can result in severe impairment of the functionality of the hand.", 'Both triple fusion and TNC arthrodesis are reasonable methods for the treatment of Mueller-Weiss disease if properly used.', 'During the period from February 2012 to June 2016, 10 patients (11 feet) suffering from Mueller-Weiss disease of stage 4 were treated by the same senior surgeon.', "Examination of the significance of non-operative treatment of Dupuytren's disease with injectable collagenase clostridium histolyticum (CCH) METHODS: Observation of 120 patients treated with injectable collagenase.", '1312 cases were subjected to FNAC of hand and wrist swellings, of which 1136 (86.', 'All the patients who presented with palpable lesions in the hand or wrist between January 2011 and July 2016 were reviewed, retrospectively.']


Cluster  1132
['Twenty-two patients, which were clinically stratified as a risk group for underlying invasive placental abnormality, underwent Doppler sonography and magnetic resonance imaging (MRI).', 'Placenta accreta is a life-threatening diagnosis , which is due to the growing number of caesarea sections becoming a serious perinatal problem .', 'Although massive haemorrhage at caesarean section ( CS ) for placenta praevia is a serious concern , effective treatment is not yet determined .', 'A furcate placental cord insertion is rare and potentially dangerous', 'Both MRI and Doppler sonography are useful for detection of invasive placental disorders.', 'To compare the role of various imaging modalities used in current practice for evaluation of invasive placental disorders, and evaluate the validity of certain imaging signs for prediction of invasive placenta.', 'Nine patients had surgical and pathological confirmation of placental adhesive disorders, of which eight were predicted correctly by MRI (true positive) while one was misdiagnosed as normal placenta (false negative).', 'Abruptio placentae is a serious problem with a high rate of maternal and fetal mortality and documented sexual dimorphism in reoccurrence .', 'Placental syndromes (PS) are characterized by endothelial dysfunction complicating placental dysfunction.']


Cluster  2020
['Adenomyomectomy is conservative surgery that is now widely applied ; however , relapse is a serious problem after the operation .', 'Adenomyosis of the uterus is a serious problem for women of reproductive age because of its possible consequence of infertility .', 'Background Severe forms of adenomyosis are a serious gynecological problem .']


Cluster  2385
['In order to help overcome possible problems of combinatorial explosion', 'However , the problem of exponential explosion']


Cluster  1035
['Nonpersistence of warfarin treatment becomes a serious problem for stroke prevention in Chinese patients with nonvalvular AF .', 'After adjusting for risk factors, laboratory findings and medication, EAEA+ was associated with ischemic stroke (hazard ratio [HR] 2.', 'To determine whether proteinuria is a risk factor for CI-AKI and death in patients with stroke undergoing cerebral angiography.', 'Proteinuria is an independent risk factor for CI-AKI and 1-year mortality in patients with stroke undergoing cerebral angiography.', 'The risk of large artery atherosclerosis and extracranial arterial stenosis, respectively, had a dose-responsive positive relationship with the tertiles of awake systolic blood pressure (SBP) CVs [large artery atherosclerosis, the second tertile, adjusted odds ratio (OR)=2.', 'Blood pressure (BP) is the most commonly applied clinical surrogate parameter for tissue perfusion and cerebral autoregulation.', 'The incidences of stroke/SE and bleeding were higher in AF and hypertension patients with elevated SBP.', 'The volume of the infarction may be a factor in the degree of renal function decline in ARI.', 'In this population, having >30PACs/h was independently associated with a higher risk of AF and overall death but only subjects with >97PACs/h had a higher risk of ischemic stroke.', 'In Chinese patients with acute atherosclerotic stroke, higher awake BP variability (measured in the subacute stage) might be associated with a higher risk of large artery atherosclerosis.']


Cluster  2106
['Treatment with CaHA results in significant improvement in the appearance of the dorsal hand and is well tolerated.', 'Calcium hydroxylapatite (CaHA) is currently the only FDA-approved soft-tissue filler indicated for augmentation of the dorsal hand.', 'To assess the safety and effectiveness of CaHA for the correction of volume loss in the hands up to 12 months.']


Cluster  1293
['A major drawback of current cartilage and intervertebral disc tissue engineering is that human mesenchymal stem cells ( MSCs ) from osteoarthritic ( OA ) patients express type X collagen ( COL10 ) , a marker of late-stage chondrocyte hypertrophy ( associated with endochondral ossification ) .', 'Recent evidence indicates that a major drawback of current cartilage- and intervertebral disc ( IVD ) tissue engineering is that human mesenchymal stem cells ( MSCs ) from patients with osteoarthritis rapidly express type X collagen ( COL10A1 ) , a marker of late stage chondrocyte hypertrophy associated with endochondral ossification .', 'Recent evidence indicates that a major drawback of current cartilage- and disc-tissue engineering is that human mesenchymal stem cells ( MSCs ) rapidly express type X collagen-a marker of chondrocyte hypertrophy associated with endochondral ossification .', 'However , recent evidence indicates that a major drawback of current cartilage- and intervertebral disc-tissue engineering is that human MSCs isolated from some arthritic patients ( a clinically relevant source of stem cells ) express type X collagen ( a marker of chondrocyte hypertrophy associated with endochondral ossification ) and osteogenic markers .', 'Previous studies have shown that a major drawback of current cartilage and intervertebral disc tissue repair is that human MSCs from OA patients express type X collagen ( COL X ) .']


Cluster  402
['The aim of this study was to compare the gastric emptying of tea with milk versus water using ultrasonography in fasted pregnant patients.', 'The upper gastrointestinal motility response varies between carbohydrates.', 'Electrogastrography in conjunction with Fast Fourier transform has limited success in detecting low grade abnormalities in gastric electrophysiological activity owing to the non-stationarity of the signal.', 'To examine whether potent stimulation of the cephalic response of digestion during small bowel CE reduces GTT and/or SBTT and thus increases the CER.', 'A randomised, single-blind and intention-to-treat noninferiority trial comparing antral area measured by ultrasound in fasting parturients and in those who were allowed to drink fluid for 90\u200amin after randomisation.', 'Defecation after eating was found in 21% of patients.', 'The gum chewing and semi-liquid diet group had first bowel sounds, first regular bowel sounds, first passage of flatus and first defecation earlier than the semi-liquid only and liquid groups.']


Cluster  390
['Patients receiving opioids were more likely to return to the ED within 30\xa0d than those receiving received nonsteroidal anti-inflammatory drugs or acetaminophen.', 'This study enrolled 64 patients who received aspirin for more than 1 month and provided written informed consent to be part of the study.', 'Multimodal analgesia with intravenous methadone administered by elastomeric perfusion at home is effective and safe.', 'Duration of analgesia was significantly longer with sufentanil 2.', 'Prophylactic administration of anti-emetics at the time of initiating opioid analgesics may reduce gastrointestinal toxicity.', 'Prescribing by APSA surgeons is largely within standard ranges, but improvement is needed, particularly regarding opioid disposal.', 'Exploratory subgroup analyses show the efficacy and safety of SFTs for the treatment of breakthrough pain in patients with cancer, regardless of their cancer stage and background opioid medication.', 'Strong opioids were initiated for 349 patients; of these, data for 298 patients were analysed.', 'The combination of these proinflammatory factors reflects a devastating problem as opioids have high abuse liability and continue to be prescribed for certain patients experiencing HIV-1-related pain .', 'Opioid-related adverse events are a serious problem in hospitalized patients .', 'Our objective was to assess the effect of sublingual fentanyl tablets (SFTs) on pain relief, quality of life, and adverse effects in patients with cancer pain, according to cancer stage and background opioid regimen.', 'Opioid titration is the best way to achieve a balance of pain relief and tolerable side effects for moderate-to-severe cancer pain.', 'The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain .', 'The guidelines on pharmacotherapy for cancer-related pain advocate active measures against the adverse effects of opioids to increase adherence to medication.', 'Pain is a serious health problem that is commonly treated with opioids , although the doses of opioids needed to treat pain are often similar to those that decrease respiration .', 'The results of this study showed that TPVBRA combined with bupivacaine and dexmedetomidine can enhance the duration and quality of analgesia without serious adverse events.', 'After the 8-week treatment and 4-week follow-up, ASV efficacy was not greater than that of SV alone regarding pain relief, as measured using the NRS, and frequency of migraine attacks, consumption of analgesics, and quality of life, as measured using the SF-36.', 'One particular problem with prescribing opioids to the elderly and long term care residents is that opioid safety and efficacy have not been well studied in these populations , and it may be difficult to predict how these patients will respond to opioid treatment .', 'Median time for discontinuing narcotic pain medication was 9 days, while that for discontinuing crutches was 15 days.', 'MORE may be a useful non-pharmacological treatment for pain and hedonic deficits among chronic pain patients at risk for opioid misuse.', 'NPs prescribe a broad range of medications across all therapeutic groups with antibacterial and analgesics being the most commonly prescribed medicines.', 'Naltrexone is an opioid receptor antagonist used to treat alcohol and opioid dependence.']


Cluster  696
['With the explosive economic development of China over the past few decades , air pollution has become a serious environmental problem and has attracted increasing global concern .', 'Increasing ozone concentrations are becoming a severe problem for air pollution in China and have an adverse impact on human health .', 'Ambient air pollution is becoming a serious environmental problem in China .', 'Urban haze has become a severe pollution problem in China .', 'Particulate matter ( PM ) pollution is a serious environmental problem in most of the cities in the Yangtze River Delta region .', 'Particulate air pollution is becoming a serious public health concern in urban cities of China .', 'Particulate pollution from anthropogenic and natural sources is a severe problem in China .', "China 's lockdown to control COVID-19 brought significant declines in air pollutant emissions , but haze was still a serious problem in North China Plain ( NCP ) during late-January to mid-February of 2020 .", 'In China , regional haze pollution is a serious environmental problem .', 'Visibility degradation caused by air pollution has become a serious environmental problem in megacities in Northeast Asia .', 'Airborne pollution is a serious , and will be a major problem in Hong Kong within the next few years .', 'With the unprecedented urbanization during the past three decades , air quality in many Chinese cities has been a serious issue which poses great challenges for urban sustainability .', 'Particulate matter ( PM ) air pollution has become a serious environmental problem in Nanjing and poses great health risks to local residents .', 'The Beijing-Tianjin-Hebei area faces a severe fine particulate matter ( PM2.5 ) problem .', 'Ambient inhalable particulate matter ( PM ) is a serious health concern worldwide , but especially so in China where high PM concentrations affect huge populations .', 'With rapid economic development , air pollution became a serious problem in China .', 'In recent years , haze pollution has become a serious environmental problem affecting cities in China .', 'Particulate air pollution is a serious problem in Beijing .', 'Particulate matter pollution in Beijing is a serious environmental problem .']


Cluster  359
['Chronic hip pain is often a debilitating problem and many patients are not good surgical candidates .', 'Postoperative persistent chronic pain ( POCP ) is a serious health problem , disabling , undermining the quality of life of affected patients .', 'Chronic post-surgical pain ( CPSP ) is a serious problem .', 'At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p\u2009<\u2009\xa00.', 'Postoperative persistent chronic pain ( POCP ) is a serious health problem , disabling , undermining the quality of life of affected patients .', 'The mean VAS Pain scores of the intervention group were significantly lower at the end of the first and fifth weeks (p< .', 'Although it did not result in a clinically meaning reduction in pain after total hip arthroplasty, perioperative administration of 60\u2009mg of duloxetine daily significantly alleviated pain in the postoperative 3\u2009weeks and morphine requirements during the postoperative 48 h. Therefore, duloxetine still shows promise in optimizing the multimodal pain-management protocols in total hip arthroplasty.', 'Pain management after arthroplasties has become a serious problem .', 'Pain in operative group was lower than nonoperative group (P\u200a=\u200a.', 'Significantly higher pain scores were observed in the topiramate group postoperatively for 2 h on all pain scales (p<0.', 'Patients in the restrictive group had significantly higher VAS pain scores at 6 hours after surgery than those in the liberal group (P=0.']


Cluster  419
['187 rDVMs and 92 specialists (referral care providers).', 'A total of 1,904 professionals (936 GP, 682 PED and 286 NUR) answered.', 'Twenty neurosurgical faculty members representing 3 clinical divisions and all 4 branch institutes completed milestone questionnaires for 26 residents semiannually, resulting in 435 resident assessments being collected and analyzed.', 'Referring veterinarians generally were satisfied with referral care, but areas exist where rDVMs and specialists differ in what they view as important to the referral process.', 'This prospective study was conducted in a single large academic medical center.', 'Nine large clinical practice sites were recruited.', 'Median rDVM satisfaction with their most recent referral care experience was 80 of 100 (mean, 75; range, 8-100).', 'We conducted a retrospective, observational, multicenter study that included 13 institutions in Japan.']


Cluster  1874
['The difference between SVD and pure-vector models is negligible and they both obtain the best performance in terms of both cluster entropy -LRB- not shown in the table -RRB- and purity . it does not provide estimates of class membership probabilities', 'The difference between SVD and pure-vector models is negligible and they both obtain the best performance in terms of both cluster entropy -LRB- not shown in the table -RRB- and purity . it does not provide estimates of class membership probabilities', 'The difference between SVD and pure-vector models is negligible and they both obtain the best performance in terms of both cluster entropy -LRB- not shown in the table -RRB- and purity . it does not provide estimates of class membership probabilities']


Cluster  1880
['The management of electronic waste ( e-waste ) is a serious problem worldwide and much of it is landfilled .', 'The generation of liquid crystal display waste is becoming a serious social problem .', 'Environmentally safe disposal of end-of-life ( EoL ) or discarded mobile phone is a serious problem on account of their ever increasing number and toxic metals contents .', 'A serious environmental problem was presented by waste batteries resulting from lack of relevant regulations and effective recycling technologies in China .', 'Spent Ni-Cd batteries bring a severe environmental problem that needs to be solved urgently .']


Cluster  2035
['Multidrug resistance is a serious problem .', 'However , the development of drug resistance against those medicines is becoming a serious concern .', 'However , their overuse has led to a serious problem of increasing drug resistance .', 'Moreover , multidrug resistance is a serious problem in epilepsy treatment .', 'However , acquired resistance to this drug has become a serious problem in the treatment of brain tumor patients .', 'Acquired resistance to these drugs , however , remains a serious problem .', 'However , acquired resistance to this drug has become a serious problem for the treatment of patients .']


Cluster  227
['Acupuncture is an effective complement to NSAIDs in the treatment of posttonsillectomy pain.', 'This review will be based on clinical evidence to choose the best choice of acupuncture treatment for LC.', 'This is a prospective randomized controlled trial to compare the efficacy of electroacupuncture and acupuncture in the treatment of CSR and to explore the safety and potential mechanism of electroacupuncture in the treatment of CSR.', 'A large randomised controlled trial found that the provision of either Alexander Technique lessons or acupuncture, for those with chronic neck pain, resulted in significantly increased self-efficacy when compared with usual care alone.', 'This is a randomized, sham-controlled trial of acupuncture treatment for CP/CPPS.', 'This study will directly compare the advantages and disadvantages of electroacupuncture and acupuncture in the treatment of CSR.', 'This study will provide a high-quality evidence to reveal the local molecular mechanism of acupuncture sensitized acupoints for patient with KOA.', 'Among patients randomized to acupuncture, the most common diagnostic framework involved the Zang-Fu syndromes for 139/160 (87%) patients.', 'The results showed that the use of TENS on acupuncture points can decrease the level of pain and opioid consumption in intubated patients under a mechanical ventilator.', 'Electrical stimulation and acupuncture points as nonpharmacological methods\xa0have been the focus of pain reduction in different patients.', 'A serious and more general concern related to the safety of acupuncture is the competence of the therapist , whether or not medically qualified .', 'The findings suggest that acupuncture can be used as an adjunctive therapy to reduce dyspnea in patients with COPD.', 'The analgesic effect of acupuncture was significant up to 3\xa0hours in the verum group (p\xa0< 0.', 'The analgesic effect of acupuncture was significant\xa0up to 3 hours in the verum group (p\xa0< 0.', 'This study will attempt to answer the question of whether or not acupuncture can improve neurologic outcome following moderate TH.', 'Acupuncture is an effective complement to NSAIDs in the treatment of posttonsillectomy pain.', 'Acupuncture-related lifestyle advice helped patients improve the way they live and care for themselves and enhanced self-efficacy and ability to use what they had learnt.', 'The safety of acupuncture is a serious concern , particularly in pediatrics .', 'With this experiment, the low-frequency electrical stimulation of two acupuncture points (BL62 and K16) was confirmed to have a positive influence on the prevention of natural cerebral aging.', 'This study will provide up-date evidence of whether acupuncture sensitized acupoints have local molecular mechanism for KOA.', 'Eighty-two patients with acute ICH were randomized to receive penetration acupuncture treatment on head combined with conventional treatment (treatment group [TG]) or conventional treatment only (control group [CG]).']


Cluster  2376
['Our objective was to compare the performance of MASCC score with PCT in predicting adverse outcomes in patients with FN.', 'Patients who underwent CP treatment in between January 2015 and January 2020 were evaluated retrospectively, using prospectively collected data.', 'PCT is a useful marker with better prognostic efficacy than MASCC score in patients with FN and can be used as an adjunct to the score in risk-stratifying patients with FN.', 'Compared with the AP patients and HS, the CP patients exhibited significantly higher catastrophising scores; higher PSQ-minor scores [29.', 'More patients in the low risk category preferred the CP model (74% vs.']


Cluster  768
['Results of this study do not support the use of tamoxifen at the dose studied as an antineutrophilic medication in the treatment of asthmatic horses in chronic exacerbation.', 'Equestrian-related injuries are a serious but underappreciated health problem and merit targeted prevention efforts for each category affected .', 'Upper respiratory disease has been a serious problem in Standardbred horses on racetracks in Ontario , with outbreaks occurring once or twice annually in late winter and early spring seasons .', 'The effectiveness of 8 weeks of equine riding was hardly observed in a static muscle test, whereas in the dynamic muscle test, the dominant and non-dominant hip extensor/flexor, the dominant hip abductor/adductor, and trunk extensor in the EQG showed a significant increase, compared to no changes in the CON.', 'Tamoxifen reduces airway neutrophilia and improves lung function in severe asthmatic horses.', 'Equine influenza virus remains a serious health and potential economic problem throughout most parts of the world , despite intensive vaccination programs in some horse populations .', 'In Study 1, there was a marked and significant improvement in the lung function of all horses treated with budesonide and dexamethasone.', 'Exercise induced pulmonary haemorrhage ( EIPH ) is a serious problem in the Thoroughbred industry .', 'This paper presents the background to a serious and widely publicised problem experienced by racing stables in the UK in recent years and , in discussing its epidemiology , lays emphasis on upper respiratory tract ( URT ) disease caused by viruses .', 'Dexamethasone and FLUT abolished the increase in R<sub>L</sub> by 75% at any histamine bronchoprovocative dose in all horses after the first week of treatment.']


Cluster  326
['A challenge for this joint approach is the large combined search space', 'The combination will always yield a bit string that resides in a higher row of the grid , so search is exhaustive . theoretical approaches become obsolete', 'This is a severe problem in pattern recognition : with an input data stream of up to 10(15 ) potential bits per second in its images , we have to pick out those images that are potentially interesting in real time at a discrimination level of 1 part in 10(6 ) , with a known efficiency .', 'A challenge for joint approaches is the large combined search space']


Cluster  1680
['Hemorrhagic fever with renal syndrome is a serious health problem in Eurasian countries .', 'Hemorrhagic fever with renal syndrome is a serious health problem in Eurasian countries , including Korea and China .', 'Hemorrhagic fever with renal syndrome ( HFRS ) is a serious public health problem in China , and is primarily caused by either the Hantaan virus ( HTNV ) or Seoul virus ( SEOV ) strains .', 'These viruses are causative agents of hemorrhagic fever with renal syndrome ( HFRS ) , which is recognized as a severe health care problem in several countries .', 'In recent years , hemorrhagic fever with renal syndrome ( HFRS ) incidence has been becoming a severe public health problem again due to its significant increase in Shaanxi Province , China .', "Hemorrhagic fever with renal syndrome ( HFRS ) is a serious public health problem in the People 's Republic of China ."]


Cluster  1749
['Our results suggest that clinicians could use a 15-minute AL-TENS application to provide significant analgesia in patients presenting with low back pain since if provides a comparable analgesia versus a 30-minute application.', 'The AL-TENS applications induced a clinically and statistically significant (p = 0.', 'Our objective was to quantify the duration and magnitude of analgesia induced by a 15- or 30-minute application of AL-TENS.']


Cluster  1140
['A major drawback of ALA is its low bioavailability .', 'Chemical degradation of drug substances remains a major drawback of extrusion .', 'Another problem with new high potential drug is that these drugs often show bioavailability problems .', 'A drawback of some of these compounds , to date , is finding ways to expand the duration of clinical efficacy .', 'A major drawback of these system is that drug release takes place before reaching the targeted area in the body .', 'A drawback of the stability of the formulation is that the unloading of the drug at the target site is very poor .', 'However , CH suffers from a drawback of poor aqueous solubility and in turn poor bioavailability limiting its clinical utility .']


Cluster  154
['Post stroke spasticity is more common in persons with hemorrhagic stroke, severe paresis and lower functional abilities.', 'Central poststroke pain is a serious problem for some patients after stroke .', "The present study developed a 'CBTI+' protocol for those with post-stroke insomnia and tested its efficacy.", 'This study provides initial evidence that CBTI+ is a feasible and acceptable intervention for post-stroke insomnia.', 'Poststroke depression ( PSD ) is a severe problem ; it will significantly increase the mortality of patients after stroke , and affect the quality of life of patients after discharge .', 'Shoulder pain and stiffness is a serious problem in patients following stroke .', 'Sequelae after a stroke are common and may lead to disability.', 'Central post-stroke pain ( CPSP ) , an intractable secondary disease , is a serious problem that occurs following cerebral stroke .', 'Approximately , one-third of them are affected by post-stroke depression ( PSD ) , making it a serious social and public health problem and anti-depressant preventive and curative therapies worth investigating .']


Cluster  915
['A major drawback of the step response technique is its high susceptibility to thermal drifts and noise which directly determine the minimum detectable binding mass .', 'The main limitation associated with the CD method is that the analysis should be performed at substrate saturation conditions ( V max regime ) .', 'A possible drawback of 24:1 could be the presence of more than one positional isomer in either a 24:1n-9 standard or in the actual sample .', 'The signal-to-noise ratio , which becomes a serious problem in field desorption mass spectrometry at low accelerating voltages , and the low instrument sensitivity were improved considerably by our use of a method of adding scans with low total ion currents obtained over a longer desorption time .', 'However , poor sensitivity due to low ion-transfer efficiency from the sample plate to the inlet capillary of the mass spectrometer under atmospheric pressure remains a serious problem .', 'Precision and limit of quantification were assessed, 25(OH)D2 and C3-epimer recovery were calculated.', 'The drift in sensitivity due to carbon deposition on the sampling cone , skimmer cone and ion lenses has been a serious problem in gas chromatography/inductively coupled plasma mass spectrometry ( GC/ICP-MS ) .', 'However , how to choose a suitable multiway calibration method for the resolution of spectroscopic-kinetic data is a troubling problem in practical application .', 'One problem with those experiments was that the dependence of the shape of the steady-state voltammogram on kinetic parameters becomes weak when the reaction rate approaches the diffusion limit .', 'The electrode contamination in electrostatic analyzers such as Langmuir probes and retarding potential analyzers ( RPA ) is a serious problem for space measurements .']


Cluster  777
['The study showed a low incidence of re-interventions and a low mortality.', 'Along with a 38% reduction in injury risk (rate difference=-1.', 'Both groups showed a statistically significant decrease in the mean plaque score across the study (P\xa0=\u20090.', 'Fewer people died in hospitals (34.', 'The rate of potentially preventable deaths decreased from 5.', 'Overall, the prevalence rate remained relatively stable at 0.']


Cluster  916
['The IG significantly improved in all ACSID scores compared to the CG (p\u200a<\u200a0.', 'In each patient with IGH, two lesions were assigned as a treatment group, whilst two lesions on another side were chosen as control.', 'According to the independent sample t test at the follow-up, significant differences between groups were found in benefit of the IG while the CG showed worse performance in the majority of neuropsychological tests.', 'Intergroup comparison revealed significant differences between IG<sub>UNFIT</sub> and CG<sub>UNFIT</sub> (P\xa0<\xa00.', 'This study included 28 patients with IGD from 27 independent families.']


Cluster  910
['A randomized clinical trial was performed with adults (N=66) that were allocated into two groups (1:1): Group A received LLLT irradiation by Diode Laser GaAlAs (780nm) with expositions twice a week during six weeks and Group B was treated with anesthetic infiltration of lidocaine 2% without vasoconstrictor once a week for four weeks.', 'The results of this study suggest that single-session intraoral LLLT is more effective than extraoral application for reducing postoperative pain.', 'Fifty-eight patients with cervical spondylosis (CS) were treated with patented technology of ozone laser combined therapy using puncture needle between August 2008 and February 2010.', 'Intraoral LLLT application resulted in a statistically significant reduction of postoperative pain in comparison with transcutaneous laser group and placebo.', "Laser and PRP group achieved the best results regarding repigmentation and patient's satisfaction.", 'The aim of this research was to evaluate the efficacies of MLS laser therapy and the 830\u2009nm laser in the treatment of patients with chronic neck pain (CNP).', 'Laser seems to be effective promoting pain reduction after coronary-arterial bypass grafting.', 'This study aimed to investigate and compare the effectiveness of low power laser therapy (LPLT) and Kinesio taping (KT) for the treatment of CTS.', 'Increase in bone density at the follow-up CBCT was significantly higher in laser than in control group (p\u2009<\u20090.', 'In comparison to the sham laser treatment, pulsed high-intensity laser therapy produced a significantly different result (p\u2009<\u20090.', 'This study will be the first that investigate the effects of local laser therapy on the salivary glands of malnourished children.', 'The laser treatments were well tolerated and resulted in clinical improvements.']


Cluster  226
['Resistance to antibacterial agents has become a serious problem for global health .', 'The antibiotic-resistance becomes certainly a serious problem when a resistant pathogen , and often multi-resistant today , is present in an infective site .', 'For example , the emergence of drug-resistant bacteria is a serious problem in the world .', 'Antibiotic resistance is a serious problem worldwide .', 'Antibacterial resistance is a serious public health problem infecting millions in the global population .', 'Antibiotic resistance is a serious public health problem .', 'Antibiotic resistance is becoming a serious problem .', 'The antibiotic resistance had become a serious problem .', 'Resistance to antimicrobials has become a serious global health concern complicating treatment strategies and increasing health-care costs .', 'The misuse and abuse of antibiotics have given rise to a severe problem of the drug resistance of bacteria .', 'Antimicrobial resistance is a serious public health concern worldwide .', 'Increasing antimicrobial resistance is a serious concern in New Zealand and worldwide .', 'The main consequences of use and abuse of antibiotics is the development and diffusion of antibiotic resistance that has become a serious global problem .', 'Thus , antimicrobial resistance has become a serious public health problem .', 'As in the entire world , resistance to antibiotics is a serious problem in our country .', 'A serious emerging problem worldwide is increased antimicrobial resistance .', 'A serious problem affecting human society is the development of bacterial resistance .', 'Widespread emergence of resistance to antimicrobial agents is a serious problem .', 'However , the emergence of antibiotic resistance due to irrational use has now become a serious public health problem .', 'Antimicrobial resistance is a serious global health concern that emphasises completing treatment course .', 'Antibiotic resistance is a serious global problem .', 'The increasing resistance of bacteria to antibiotics is a serious problem , caused in part by excessive and improper use of these drugs .', 'Microbial resistance to majority of the available antimicrobial agent is a serious and global problem .', 'Drug resistance caused by excessive and indiscriminate antibiotic usage has become a serious public health problem .', 'Antibiotic resistance is a serious problem worldwide .', 'Antimicrobial resistance is a serious healthcare concern affecting millions of people around the world .', 'Antimicrobial resistance remains a serious problem that results in high mortality and increased healthcare costs globally .', 'Antibiotics are also used in some countries , but bacterial resistance to antibiotics is a serious worldwide problem .', 'Antibiotic resistance is a serious problem .', 'Antibiotic resistant bacterial infection is currently a serious public concern .', 'However , because of the long-term and irresponsible use of antibiotics , resistance to antibiotics has become a serious problem directly threatening the public health worldwide .', 'According to the World Health Organization ( WHO ) , antibacterial resistance is a serious problem worldwide .', 'Microbial resistance is a serious current public health problem , in part because of the wide use of antimicrobial drugs .', 'The bacterial resistance to antibiotics constitutes more than ever a severe public health problem .', 'Antibiotic resistance is a serious public health problem throughout the world .']


Cluster  159
['PLK-1 expression is associated with metastatic potential in cutaneous melanoma.', 'Perioperative treatment with BRAF inhibiting agents in BRAFV600E mutated Stage III melanoma patients facilitates surgical resection and affords satisfactory disease free survival.', 'Hepatic arterial therapy with DEBDOX is safe with minimal QOL changes in treating unresectable liver-dominant melanoma metastasis.', 'The primary aim was to investigate the metabolic response to pazopanib monotherapy and pazopanib plus paclitaxel in patients with BRAF wild-type melanoma.', 'Dermoscopically, the presence of irregular peripheral streaks and ulceration were positive predictors of BRAF-mutated melanomas with a statistically significance value, while dotted vessels were more represented in wild-type melanomas.', 'To correlate the dermoscopic characteristics of primary cutaneous melanomas with BRAF mutational status.', 'We immunohistochemically assessed PLK-1 expression in neoplastic and stromal compartments of 96 cutaneous melanomas, and analyzed associations between PLK-1 expression and clinicopathological characteristics.', 'We report our experience in the management of patients treated with dabrafenib for metastatic melanoma, focusing on the monitoring of pigmented lesions.']


Cluster  319
['Non-enzymatic glycation , accompanied by the formation of free radicals , represents a serious problem in diabetes mellitus .', 'Possibly , a problem with pharmacological activators is that they cause generation of mitochondrial reactive oxygen species .', 'A randomized, single-blind placebo-controlled study on the effect of Brazilian green propolis on serum artepillin C levels was conducted with healthy volunteers.', 'In the WBC group subjects, we recorded a statistically significant decrease in the concentrations of most of the parameters of oxidative stress with an accompanying increase in plasma concentrations of non-enzymatic antioxidants (total antioxidant status and uric acid).', 'One problem with scavenging-type antioxidants is that secondary radicals derived from them can often themselves do biologic damage .', 'As flavonoids are consumed in high content in our daily life , their potential to interfere with molybdenum hydroxylases could be a serious concern for consumer safety .', 'One of the most common complications in diabetic nephropathy is generation of high levels of ROS which can be regulated by herbal antioxidants', 'The suggested method is an attempt to achieve a realistic estimate of bioavailability which overcomes the inherent drawback of root metal contamination in the bioavailability indices so far reported .', "Resveratrol ( 3,5,4'-trihydroxy-trans-stilbene ) is an unfulfilled promise for health care : its exploitation is hindered by rapid conjugative metabolism in enterocytes and hepatocytes ; low water solubility is a serious practical problem .", "In order to estimate the effect of a plant extract based supplement in apparently healthy volunteers' oxidative stress markers, a double-blind and placebo controlled intervention was performed.", 'Oxidative stress ( OS ) is a common pathogenic factor involved in the onset of several diseases in humans , from immunologic disorders to malignancy , being a serious public health problem .']


Cluster  2168
['Diabetic foot ulcers ( DFUs ) are a serious and common problem in patients with diabetes mellitus and constitute one of the major causes of lower extremity amputation .', 'Diabetic foot ulcer is considered as a major health problem that predisposes to limb amputation.', 'Chronic wounds , such as diabetic foot ulcers , represent a serious clinical problem for patients and clinicians .', 'The study was a randomized-controlled, prospective investigation between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds at single extremity.', 'The study included 56 patients of both sex from 18 to 80\xa0years, with clean chronic diabetic foot ulcers divided into 2 equal groups.', 'Foot ulceration is a serious problem for patients with type 2 diabetes ( T2D ) , and the early detection of risks for this condition is important to prevent complications .', 'Foot ulceration ( FU ) remains a serious concern for patients worldwide .', 'A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration.', 'Foot ulceration remains a serious health concern for diabetic patients and has a major impact on the cost of diabetes treatment .', 'Ulcers of the skin of the feet of diabetic patients are a serious health problem and a major cause of amputations .', 'Diabetic foot ulceration is currently a serious medical problem and has , therefore , attracted much research attention during the last two decades .', 'A double-blind, randomized study included 60 patients with a chronic diabetic wound treated at the University Medical Center Ljubljana between October 1, 2012 and December 1, 2014.', 'A prospective observational study was conducted on 99 patients presenting with a diabetic foot ulceration.']


Cluster  81
['C1-C2 injury represents a serious concern , possibly life-threatening , especially in the elderly .', 'However , the need for replacement of the Ace wrap by other methods due to pain indicates the potential for a serious problem with this intervention .', 'Retained surgical gauze is a preventable problem but continues to occur periodically .', 'Emergent surgical procedures are high-risk for retained sponges, even when sponge counts are performed and found to be correct.', 'The inherent high rate of reoperation remains a serious problem .', 'At the acute stage they present a serious diagnostic problem since signs of polytrauma are predominant .', 'Despite careful placement by experienced surgeons , ST-related complications have been and continue to be a serious , sometimes life-threatening problem .', 'Subcutaneous infiltration of fluid is not always perceived as a serious problem .', 'However , the need for replacement of the Ace wrap by other methods due to pain indicates the potential for a serious problem with this intervention .', 'A troublesome problem which can occur is post-operative , intraluminal grommet obstruction by blood or viscous mucoid secretions .', 'Injuries of the popliteal region remain a serious problem as far as the outcome is concerned .', 'However , the intense intraoperative pain remains a serious problem .', 'However , the non-specific cellular damage in the surrounding normal tissue is still a serious concern .', 'Among the possible complications , anastomotic leakage is still a troublesome concern .', 'Any sign of clinic situation should lead to ceasing of the procedure immediately ; otherwise , it can cause a life-threatening problem of abdominal compartment syndrome .']


Cluster  1407
['Suicide is the second leading cause of death among youths in many countries , and is a serious concern for public health .', 'Suicide is a serious public health concern for US youth .', 'Youth suicide is becoming a serious problem in Kazakhstan .', 'The high frequency of suicide attempts during adolescence is a serious public health concern .', 'Suicidal ideation is a serious mental health concern reported by adolescents .', 'Suicide is the second leading cause of death among youth and has become a serious public health problem .', 'Studied mostly in developed countries , the increased prevalence of suicide among youth , worldwide , is a preventable public health concern .', 'Youth suicide is a serious public health problem in the United States .', 'Suicide is 1 of the top 3 leading causes of death in the pediatric population and a serious public health concern .', 'Adolescent suicide behavior should be viewed as a serious problem .', 'Adolescent depression with related suicidal behavior is a serious health problem .']


Cluster  676
['A Motivation for Selection of Medical Study (MSMS) questionnaire was developed using extensive literature review followed by Delphi technique.', 'PDSS and PDSS-SR possessed excellent psychometric properties (internal consistency, test-retest reliability) and convergent validity.', 'In last few years, the use of confirmatory factor analysis (CFA) has become dominant in structural validation of psychological tests', 'The MSMS questionnaire consisted of 3 factors (subscales) and 8 items.', 'The evaluation of the original 5 factors revealed low internal reliability for the general factor and reduced activity, and high intercorrelations between all sum scores.', "Analysis was done for using repeated measures ANOVA and Friedman's test.", 'The aim was to develop a Swedish version of the QPR (QPR-Swe) and explore its psychometric properties in terms of factor structure, internal consistency, construct validity and sensitivity to change.', 'Factor analysis identified three latent factors (53% of the variance): decentering (DC), distress tolerance (DT), and residual symptoms (RS), which were equivalent across CT and MBCT.']


Cluster  2155
['Snakebite envenoming is a serious global public health problem , and international initiatives , under the coordination of the World Health Organization and its regional offices , are being developed to reduce the impact of this neglected tropical disease .', 'A snakebite is a serious and important problem in tropical and subtropical cities .', 'Snakebites is a neglected disease and in Brazil is considered a serious health problem , with the majority of the snakebites caused by the genus Bothrops .', 'Snakebite is a serious medical and socio-economic problem affecting the rural and agricultural laborers of tropical and sub-tropical region across the world leading to high morbidity and mortality .', 'Snakebites are a serious problem in public health due to their high morbimortality .', 'Although venomous snakebites are not a serious world wide problem from the epidemiological point of view and are rare under our conditions , it is frequently a very serious and life threatening matter .', 'Snakebite is a serious problem in rural India where several highly venomous species are commonly found in and around agricultural areas where prey such as rodents and amphibians are abundant .', 'Accidents involving snakebites constitute a serious public health problem in many regions around the world .', 'Snakebite envenoming is a serious public health problem in Central America , where approximately 5,500 cases occur every year .', 'Snakebite envenomation is a serious medical problem in many tropical developing countries and was considered by WHO as a neglected tropical disease .', 'Snakebites represent a serious global public health problem , especially in tropical countries .', 'Although low case fatality and mortality rates were observed , much can still be done to prevent snakebites as they continue to be a serious public health problem considering the severity and potentially high economic impact for the individual and to society .', 'Snakebite envenoming is a serious and life-threatening but neglected problem in the tropics .', "Snakebite is a severe medical , social , and economic problem in many parts of the world , chiefly in tropical and subtropical nations where majority of the world 's dangerous snakes are found and where access to treatment is limited .", 'Snake bites represent a serious public health problem in many areas of the world .', 'Snakebites are a serious public health problem and , in the Amazon , the', 'Snakebite envenoming is a serious problem in Myanmar .']


Cluster  2081
['Postoperative mediastinitis remains a serious surgical problem , complicating 0.4 % to 5 % of all cases .', '[ Anaerobic mediastinitis -- a serious surgical problem ] .', 'To test the applicability of the MagedanzSCORE in predicting the risk factors for mediastinitis in patients undergoing coronary artery bypass grafting at a cardiology reference hospital.']


Cluster  2006
['At 1-week post-treatment, and relative to the PC, the IBM group reported greater reductions in negative/threat interpretations of ambiguous information in favour of positive/benign biases.', 'Participants in the experimental condition reported more favorable attitudes in the post-test compared to the pre-test, t(43)=4.', 'A paired t test showed that confidence was significantly higher in the posttest than in the pretest for both groups.', 'The E\xa0+\xa0RP and E\xa0+\xa0SB condition resulted in a larger decrease of CFDD and threat belief ratings than the control condition, whereas these reductions did not differ between the E\xa0+\xa0RP and E\xa0+\xa0SB condition.', 'After the lecture, demonstration and simulation training, there was a statistically significant difference between groups in terms of knowledge (p\xa0<\xa00.', 'Trainees on both simulators demonstrated a significant improvement (p < 0.', 'The experimental group showed greater improvement on both the PAS (p\u200a<\u200a0.', 'In both groups, both the post-test MIPs and MEPs were significantly higher than the pre-intervention ones (p< 0.']


Cluster  1227
['In total, 137 metabolites were identified and quantified.', 'Our results thus reveal a serious limitation to the reproducibility of current lipid profiling experiments and reveal challenges to the integration of such data from different laboratories .', 'An ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) technology was used to analyze the urine metabolites of 75 cases of essential hypertension group (EH) and 75 cases of healthy control group (HC).', 'A drawback of current open-path Fourier transform infrared ( OP/FT-IR ) systems is that they need a human expert to determine those compounds that may be quantified from a given spectrum .', 'A major drawback of liquid chromatography-mass spectrometry is that no standard spectral libraries such as NIST and Wiley for GC-MS are available to facilitate the identification of unknown compounds .', 'This is a severe problem for metabolite quantification and data analysis , as peak integrals do not necessarily correspond across all spectra in a set .', 'Ionization suppression is a serious problem in liquid chromatography/mass spectrometry-based metabolomics , and stable isotope dilution-based comparative quantification is one of the most important methods of overcoming this problem .', 'Single-photon ionization mass spectrometry ( SPI-MS ) is a versatile and powerful analytical technique for online and real-time analysis of organic species ; however , it is confronted with an intrinsic drawback of lacking structural information on the investigated molecules , let alone differentiation of isobaric compounds .']


Cluster  947
['This species acts as a vector of Plasmodium vivax , an important etiological agent of malaria , which represents a serious public health problem .', 'Insecticide resistance in the malaria vector , Anopheles gambiae , is a serious problem , epitomized by the multi-resistant Akron strain , originally isolated in the country of Benin .', 'Malaria , the most virulent parasitic disease , has become a devastating health problem in tropical and subtropical regions , especially in Africa , due to favorable temperature and rainfall conditions for the development of the causative vector .', 'The highly attenuated NYVAC vaccinia virus strain has been utilized to develop a multiantigen , multistage vaccine candidate for malaria , a disease that remains a serious global health problem and for which no highly effective vaccine exists .', 'Malaria still remains a serious health problem in large areas of the world , and in this article , recent research progress mainly made by us toward malaria vaccine development has been reviewed .', 'Malaria is a serious public health problem , the control of which involves actions directed against its vector , mosquitoes of the genus Anopheles Meigan , 1818 .', 'This result reveals a possible drawback of the development of anti-malarial vaccines , especially considering the wide endemic areas for both parasitoses .', 'The emergence of pyrethroid resistance in Anopheles gambiae has become a serious concern to the future success of malaria control .', 'We revisit this result using the same temperature data , now updated to the present from 1950 to 2002 for four high-altitude sites in East Africa where malaria has become a serious public health problem .']


Cluster  1471
['Hindi : ek diwar ise surakshit karane ke liye banayi gayi thi . noisy data', 'Hindi : ek diwar ise surakshit karane ke liye banayi gayi thi . noisy data']


Cluster  1424
['Biofouling is a serious problem in industrial recirculating cooling systems .', 'Microbial fouling is a serious problem in open recirculating cooling water systems .', 'Biofouling poses a serious concern for the district cooling ( DC ) industry .', 'Biofilm formation on antifouling coatings is a serious concern in seawater cooling systems and the maritime industry .', 'Biofilms are a serious problem in industrial recirculating cooling water systems .']


Cluster  2344
['is a serious problem that can develop during liver transplantation ( LT ) and is related to morbidities such as insufficient blood supply causing graft dysfunction or impractical closure of the abdominal wall leading to graft compression .', '[ Apropos of a fatal and delirious acute hepatitis . Current physiopathological therapeutic considerations ] .', 'One problem with plasma exchange as supportive therapy in these cases is that massive citrate infusion has an adverse effect on the hepatic energy charge , which may be a serious risk in these patients .', 'One problem associated with ABMi therapy is that general anesthesia is required to obtain 400 ml bone marrow fluid from liver cirrhosis patients .', '[ Post-transfusion hepatitis : a serious problem ] .', "A major drawback of the perfusion of blood through livers was a considerable decrease in the primates ' haemoglobin and platelet levels .", 'Severe hyperkalemia is a serious problem during orthotopic liver transplantation .', 'It has been reported that steatosis may be a serious problem in patients who donate a part of their liver .']


Cluster  1379
['Skin elasticity measured via a Cutometer was significantly improved 12\xa0weeks after treatment at all treated sites (P<.', 'Overall, we demonstrated a significant increase in skin elasticity (+7.', 'To investigate skin responses to sustained loading in a sitting position and possible differences between two fabrics.', 'Sitting on a hard surface causes skin barrier changes at the gluteal skin in terms of stratum corneum hydration and TEWL.', 'The heated mechanical arm and baby torso accurately distinguished products for skin dryness.', 'A simulated skin substrate was applied to a heated mechanical arm or baby torso.']


Cluster  1463
['Community-acquired pneumonia ( CAP ) is a serious health problem in Chile .', 'Pneumonia is a serious problem worldwide .', 'Community-acquired pneumonia ( CAP ) is a serious social and medical problem in the elderly .', 'In Morocco , pediatric pneumonia remains a serious public health problem , as it constitutes the first cause of mortality due to infectious diseases .', 'Community-acquired pneumonia in adults is a serious health problem in the ambulatory care setting .', 'Globally , pneumonia is a serious public health concern and a major cause of mortality and morbidity .', 'Community-acquired pneumonia ( CAP ) is a serious clinical problem , causing hospitalization in about 20 % of cases and death in up to 16 % of hospitalized patients .', 'S. pneumoniae infection remains a serious public health concern despite the availability of vaccines covering up to 23 of more than 94 known serotypes .', 'The contamination of C. pneumoniae stock cultures , frequently used in the microimmunofluorescence test , with human pathogens , could pose a serious problem in C. pneumoniae serology .', 'Antimicrobial resistant S. pneumoniae has already become a serious problem in China .']


Cluster  469
['The main problem with this approach is that it only indicates that an overexposure has occurred rather than providing the ability to prevent an overexposure or detect its cause .', 'The problem with this approach is that it can have difficulty penetrating into the deeper layers of mucosae or skin , and for this reason , its beneficial affects are not routinely predictable .', 'However , a problem with these markers is that they are too large to be released from cells without cell death or loss of membrane integrity .', 'We found the Dopplex device to demonstrate suboptimal accuracy and repeatability in assessing ABI/PVR, and it was deemed unsuitable for use in our community.', 'The problem with this approach is that the investigator may inadvertently leave out the most beneficial treatment .', 'However , a commonly incomplete functional suppression represents a serious drawback of this technology .', 'A common drawback of DOACs is the lack of an available reversal agent .', 'One problem with the technique is that results indicate uptake of labeled antisera , rather than amounts of coating substances .', 'This is a severe problem because it often masks broad and weak ENDOR signals .', 'The problem with conventional markers is that they are often released too late or at too low a level to be detected in time to trigger effective treatment .', 'However , a major drawback of bioluminescence imaging is that it does not allow visualization of host-parasite interactions at a cellular level .', 'However , a drawback of biologic imaging is that it is not specific for infection .']


Cluster  776
['Allergies to various inhalative allergens are a serious problem in the bakery and confectionery industry .', 'Hidden allergens in food products are , especially for peanut-allergic consumers , a serious problem because even low amounts ( approximately 200 microg ) of peanut can elicit allergic reactions .', 'Cashew and pistachio allergies are considered a serious health problem .', "Baker 's asthma is a serious problem for a significant proportion of workers in bakeries , confectionaries , and the food industry .", 'Many tree nuts are considered to be a serious problem in food safety , because of the presence of causative factors in IgE-mediated food allergies .', "Baker 's asthma , a typical occupational allergic disease , is a serious problem in the food industries .", 'Cereal-associated allergy is particularly considered a serious problem , because cereals are essential in our daily diet .', 'Allergic reactions to peanuts are a serious health problem because of their high prevalence , associated with potential severity , and chronicity .']


Cluster  1402
["It is not a life-threatening disease , but since patient 's satisfaction to the treatment is known to be as low as 50 % , chronic constipation still remains a clinically challenging problem .", 'Chronic idiopathic constipation , especially the slow transit type , is a troubling problem often afflicting young women .', 'This study was performed in patients aged 4-18 years, and the patients were diagnosed to have functional constipation according to the Roma III diagnostic criteria.', 'Chronic constipation , in addition to diarrhoea , gall bladder dysfunction and incontinence , is increasingly regarded as a serious problem and for the first time , is now considered in the current guidelines of the professional societies .', 'Constipation is often a preventable problem in health care ; therefore health professionals must have the appropriate knowledge to help patients prevent this common complaint occurring .', 'To treat functional constipation, both electroacupuncture (EA) therapy and transcutaneous electric nerve stimulation (TENS) are safe and effective.', 'Individuals with functional constipation will be randomly allocated to receive either EA or TENS (n\u200a=\u200a51, each), 3 times per week for 8 weeks.', '- This randomized, double-blind controlled trial included 49 female patients aged 20 to 50 years and diagnosed with constipation according to the ROME III criteria (Diagnostic Criteria for Functional Gastrointestinal Disorders) and the Bristol Stool Form Scale.', 'In clinical practice constipation is often an overlooked aspect of patient care and first gains attention when it has become a severe problem for the patients .', 'Patients with functional constipation (Rome III criteria) were randomized to VIBRANT or sham capsule treatment for 8\xa0weeks and underwent scintigraphic colonic transit measurements during week 8.', 'Constipation is not a life-threatening problem ; however , affected patients may suffer a great deal of angst and have their lives disrupted , especially when it is left untreated .']


Cluster  1581
['The primary end point occurred in 15.', 'Before the third session, the counts were 15.', 'The mean follow-up period was 15.', 'The mean follow-up period was 18.', 'The mean time of wound healing was 15.']


Cluster  2114
['Fibrosis is a severe and progressive sequel of many pulmonary diseases , has no effective therapy at present and , consequently , represents a serious health problem .', 'Idiopathic pulmonary fibrosis ( IPF ) is a serious lung problem with advancing and diffusive pulmonary fibrosis as the pathologic basis , and with oxidative stress and inflammation as the key pathogenesis .', 'Idiopathic pulmonary fibrosis ( IPF ) is a fatal growing problem , with limited therapeutic options .', 'Pulmonary fibrosis is a vexing clinical problem with no proven therapeutic options .', 'Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an often-fatal condition associated with endothelial damage and abnormalities of the coagulation system.']


Cluster  349
['Radial artery is the most exploited access by cardiologist fellows, leading to reduction in minor bleedings and higher success compared with femoral access.', 'Because inability to secure vascular access is a life-threatening problem , it is important to consider all possible options in each patient .', 'Unfortunately , the creation as well as the use , maintenance and the treatment of vascular access complications nowadays still remain a serious clinical problem despite pharmacological and technical advances during the last decade ( 2 ) .', 'Obtaining intravascular access can be challenging or even impossible in several clinical situations.', 'In this randomised trial we demonstrate that an easy to perform PSS is as effective at achieving haemostasis as 10minutes of manual pressure for catheter ablation procedures.', 'We randomised 200 consecutive patients who were referred for electrophysiology procedures at two different hospitals to either 10minutes of manual pressure or a PSS over the femoral vein and determined the incidence of vascular access site complications.', 'Our study demonstrates that it is probably safe to ambulate patients who undergo diagnostic cardiac catheterization as early as 20 min after deployment of the 6 Fr Angioseal® closure device.', 'Despite the increasing acceptance of transradial approach , radial artery occlusion ( RAO ) continues to be a vexing problem of transradial access and limits utility of the radial artery as an access site in the future .', 'Patients undergoing angiography from the common femoral artery approach were included in the study if they received a 6 Fr Angioseal® closure device.', 'In all, 256 patients undergoing diagnostic coronary angiography via the right radial artery in a\xa0high-volume medical center were randomized to either the SCA or TCA group.', 'In this multicenter prospective study, cardiology fellows selected the access site (among femoral, right and left radial artery) for coronary angiography.']


Cluster  1923
['Twenty patients underwent treatment using an ablative fractional laser and were randomized with respect to the side of the face treated with an MGF-containing cream or control cream.', 'The aim of this study was to evaluate and compare the efficacy of CO<sub>2</sub> fractional laser photothermolysis followed by topical application of B-Resorcinol and Glycyrrhetinic acid vs.', 'Intense pulsed light and pulsed dye laser with nonpurpuric settings were equally effective in reducing facial erythema.', 'The ablative CO<sub>2</sub> lasers, in combination with topical betamethasone solution and NB-UVB, achieved marked to excellent improvement on white patches assessed by dermatologists.', 'The purpose of this study was to investigate the effect of three types of fractional lasers in the treatment of stable non-segmental vitiligo.', 'Fractional CO<sub>2</sub> laser therapy combined with NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of vitiligo.', 'The treatment protocol with ablative CO<sub>2</sub> lasers, in combination with topical betamethasone solution and NB-UVB, was suitable for stable non-segmental vitiligo.', 'Hand solar lentigines of eleven volunteers were divided into two groups: Group A spots received CO<sub>2</sub> fractional laser photothermolysis followed by 4 weeks topical application of B-Resorcinol and Glycyrrhetinic acid, and Group B spots received only 4 weeks topical treatments.', 'This study evaluated the efficacy of RF in the treatment of rosacea compared with pulsed dye laser (PDL).', 'Topical application of B-Resorcinol and Glycyrrhetinic acid is effective to lighten hand solar lentigines after 4 weeks of treatment, with or without a previous fractional laser photothermolysis.', 'In 22 healthy female subjects, three 4 × 3 cm regions on the right forearm were randomized to: fractional laser plus topical lidocaine cream (Group LaserAnes), sham irradiation plus topical anesthesia (Group Anes), and sham irradiation plus sham anesthesia (Group Con).']


Cluster  702
['The analysis included data from 34 patients under observation for 3 to 17 (mean 10.', 'The study included 39 patients.', 'Of 72 patients, 48 had PMI.', 'Thirty-one patients with a PID diagnosis were included.', 'Among 59,427 patients, 34.', 'In total, 40 patients in the study group and 39 patients in the control group completed the study.', 'In all, 34 patients received PA and 35 SA.', '36 patients completed the study.', '33 FMD patients were enrolled.', 'Thirty-two patients completed the study.', 'Of the 1036 patients included in the study, 35 (3.', 'The sample size in a full-scale study must comprise at least 382 patients on the basis of the assumptions in the pilot.']


Cluster  444
['Is There a Drawback of Converting a Laparoscopic Colectomy in Colon Cancer ?', 'Multiple colorectal polyps with a diameter in the range of 10-19 mm are unable to be retrieved through a 3-mm endoscopic channel by the aspiration method.', '284 Patients with a total of 296 colorectal carcinomas were evaluated.', 'One hundred thirty five patients (483 polyps) were diagnosed with colorectal neoplasm, and 64 patients (225 polyps) were enrolled and randomly allocated into the Net forceps group (NET) and the Catcher Tagged group (TAG).', 'There are few comparative studies on the historical changes in the clinicopathologic characteristics of colorectal polyps in Korea.', 'A total of seven consecutive patients with giant pedunculated colorectal polyps (≥3\xa0cm) were prospectively enrolled.', 'Routine LUS during resection of colorectal cancer is not recommended.', 'In total, 28 consecutive patients with right-sided colon cancer were treated by laparoscopic right hemicolectomy using a cranial approach.', 'A total of 140 colorectal surgery cases were included.', 'LCI improves the detection of colorectal polyps and adenomas during colonoscopy.', 'Colorectal neoplasms present a serious diagnostic and therapeutic problem .', '1023 LNPCPs underwent both successful EMR and first surveillance colonoscopy (median size 35\u200amm, IQR 30-50\u200amm); 124 (12.', 'The use of antibiotics after EMR of colon polyps to prevent infection did not affect the prognosis of patients.', 'Inadequate polypectomy leads to incomplete resection, interval colorectal cancer, and adverse events.', 'This observational study included 157 patients who underwent major elective colorectal surgery.', 'A total of 102 patients who underwent elective open surgery for colorectal disease between October 2012 and August 2014 were randomly assigned to a WEP group and a WEP (-) group.']


Cluster  2173
['Findings highlight the challenging contexts that many study participants face, and shed light on the potentially influential role of health educators and interviewers in intervention implementation and data collection.', 'Using a cross-sectional, non-comparative design, a community-based program evaluation was conducted in 29 organizations implementing HT as part of their core service programs.', 'Healthy Together (HT) is family-centered program to support healthy eating and physical activity designed for implementation in community organizations serving families who may be experiencing vulnerabilities (e.g., related to low income, isolation, ethnicity, immigrant/refugee status, and/or Indigenous background).', 'Interventions found to be effective in research settings are often not as effective when implemented in community settings.', 'At follow-up, children in the intervention schools did not differ from the control schools in number of illness days [odds ratio (OR)I-arm I: 0.', 'Given the variability in our findings, more research needs be conducted with a larger sample to determine, with greater rigour, the efficacy of the intervention within samples of healthy children from low-SES backgrounds.', 'The multicomponent Hi Five intervention achieved no difference in the number of illness days, illness episodes or illness-related absenteeism among children in intervention schools compared with control schools.']


Cluster  378
['Our objective was to compare postoperative pain relief and operating field condition of single-shot, low-thoracic epidural anesthesia combined with general anesthesia versus general anesthesia alone.', 'Patients with low back pain who received any opioid, intravenous opioid, or intramuscular opioid had significantly increased proportions of a return visit within 30\xa0d (32% [OR 1.', 'Epidural steroid injection for low back and leg pain has been shown to result in a positive clinical outcome.', 'The aim of this study was to compare the incidence of post-dural puncture headache and backache after different periods of bed rest following spinal anesthesia.', '30\xa0mg ketorolac administered intravenously just before the operation could decrease incidence and severity of intraoperative shoulder pain in patients undergoing cesarean section.', 'Single-shot low-thoracic epidural anesthesia combined with general anesthesia provides better pain control than general anesthesia alone.', 'The use of low-dose isobaric bupivacaine in combination with 10 mL of saline EVE allows for faster motor recovery and time to meet PACU discharge criteria in patients undergoing short obstetric procedures.', 'A distressing problem of persistent postoperative frontal pain is discussed in detail .', 'Parturient abdominal girth and vertebral column length have significant predictive value in determining the cephalad spread of spinal anaesthesia with hyperbaric bupivacaine in term parturients.', 'Use of i.v. paracetamol for postoperative pain is well documented, but it is unclear if it can reduce the consumption of opioids during patient-controlled epidural analgesia (PCEA) in labouring parturients.', 'Post-dural puncture headache ( PDPHA ) has been a vexing problem for patients undergoing dural puncture for spinal anaesthesia , as a complication of epidural anaesthesia , and after diagnostic lumbar puncture since Bier reported the first case in 1898 .', 'Neurological injuries after epidural/spinal analgesia are a serious but uncommon problem .', 'This study compares 30-day return rates after administration of various pain management modalities for emergency department (ED) patients with low back pain.']


Cluster  673
['The absence of early mortality and the satisfactory clinical and haemodynamic results demonstrated the overall safety and efficacy of the Perceval S valve.', 'The most serious problem after mitral valve replacement with the ball valve prosthesis is that of thromboembolic complications .', 'Though not very frequent , this is a serious concern because patients are high risk for surgical aortic valve replacement ( SAVR ) by definition , and explanting the endocarditic prosthetic valve followed by SAVR increases risk even higher .', 'Once patients have tolerated combined surgery during the early postoperative period, good survival rates equaling those of isolated valve surgery can be expected.', 'Indigenous patients presenting for redo valve surgery represent a complex and comorbid group of patients, with outcomes worse than expected in a young population, albeit comparable within study groups.', 'Thrombotic obstruction of prosthetic valves is a serious problem .', 'A total of 100 patients with aortic stenosis undergoing aortic valve replacement (AVR) with or without concomitant procedures were prospectively included.', 'Aortic valve replacement in the young patient represents a serious problem in terms of anticoagulation and limited durability of the bioprosthesis .', 'Patients eligible for TAVR with an Edwards SAPIEN 3 valve were included in this prospective observational study.', 'Heart valve disease is a serious and growing public health problem for which prosthetic replacement is most commonly indicated .', 'Isolated crystalloid Celsior may be an optimal and safe myocardial protection strategy in aortic valve replacement operations.', 'Prolonged operative times , potentially leading to increased morbidity , are a possible drawback of minimally invasive aortic valve replacement .', 'Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing valve replacement surgery with concomitant RFA.', 'Heart valve repair or replacement is a serious problem .', 'Traumatic intravascular hemolysis after heart valve replacement can be a serious problem .']


Cluster  793
['In China groundwater contamination has become a serious problem .', 'At present , water pollution is still a serious problem in some parts of China .', 'Water pollution is a serious problem in China .', 'Inorganic pollutants in groundwater , such as sulfate and nitrate , have been a serious problem in China for decades .', 'Black-odorous rivers and lakes are a serious environmental problem and are frequently reported in China .', 'In this research , Shenzhen City , which has a serious waterlogging problem , was used as a case study .', 'Water pollution from small rural industries is a serious problem throughout China .', 'Groundwater pollution is a serious problem in north China .', 'As the second largest inland river basin situated in the middle of the Hexi Corridor , Northwest China , the Heihe River basin ( HRB ) has been facing a severe water shortage problem , which seriously restricts its green and sustainable development .', 'Negative lake water balance in recent years leads to a serious water shortage problem in the Poyang Lake .']


Cluster  2146
['THE COMMON EARTHWORM AS A SERIOUS ECONOMIC PROBLEM .', "Second to malaria as the world 's most widespread parasitic disease , infection by trematodes is a devastating public health problem .", "Wide distribution of ecto- and endoparasites in cattle is a serious problem in the sustainability of a farm , due to the negative impact on animals ' health and productivity .", 'Human enteroparasites are considered a serious public health problem in underdeveloped countries located in world regions with tropical , subtropical and equatorial climates .', 'Hookworm infection : A severe health problem in periurban community of North central , Nigeria .', 'The presence of trematodes in snails could pose a serious health problem in Iran .', '[ Parasitic worm infestations of food origin : a serious environmentally related public health problem ] .', 'Worms are still a serious problem for poor and developing countries .']


Cluster  601
['The highest visible and measurable fluorescence was yielded by 20\xa0mg/kg.', 'Linked color imaging (LCI), a recently developed technology, uses a laser endoscopic system to enhance the color separation of red color to depict red and white colors more vividly.', 'The high degree of absorption and scattering of photons propagating through biological tissues makes fluorescence molecular tomography ( FMT ) reconstruction a severe ill-posed problem and the reconstructed result is susceptible to noise in the measurements .', 'Currently , a serious problem obstructing the large-scale clinical applications of fluorescence technique is the shallow penetration depth .', 'Ureteral fluorescence imaging using MB proved to be safe and feasible.', 'The positive predictive value of fluorescence was 100%.', 'A drawback of the method appears due to the measuring principle , where photons detected in the diffusive tissue are influenced by the sample absorption but also scattering properties leading to variation in the photon pathlength .', 'Fluorescence imaging using indocyanine green (ICG) is undergoing extensive development.', 'Visible light spectroscopy is a reliable, continuous adjunct to free tissue transfer monitoring with advantages over intermittent hand-held Doppler and clinical examination.']


Cluster  2077
['Contamination of water on toxic blooms of cyanobacteria has occurred in many regions of the world and could be a serious public health problem .', 'The prevalence of cyanobacterial blooms in fresh water bodies worldwide has become a serious environmental problem .', 'The toxic cyanobacteria are a serious problem for water supply systems , recreation , and agriculture .', 'Blooms of cyanobacteria , produced mainly as result of the pollution of water bodies with excessive amounts of phosphorus , represent a severe environmental problem ; not only do they affect the normal equilibrium of the aquatic ecosystem but may also affect animal and human health .', 'Cyanobacteria and cyanotoxins constitute a serious environmental and human health problem .', 'In recent years cyanobacteria blooms have become a severe problem in Taihu Lake , a large shallow eutrophic lake in China .', 'The increasing cyanobacterial blooms have recently been considered a severe environmental problem .', 'The microcystins produced by cyanobacteria pose a serious problem to human health , if they contaminate drinking water or food .']


Cluster  1605
['However , a major drawback of the genetic analyses is that the specimens investigated are usually damaged , as parts of skin , bone , or a tooth have to be removed for DNA extraction .', 'A drawback of this approach is that it does not consider the presence of alternative RNA structures .', 'A major drawback of most methods is the need to average the explanatory variables across the entire region or genomic element .', 'However , a major drawback of such methods is the non-linear relationship between the amounts of DNA and CLPs , which makes quantitative data interpretation difficult .', 'However , a common drawback of these methods is that their identified mRNA isoforms contain a high percentage of false positives , especially for genes with complex splicing structures , e.g. , many exons and exon junctions .', 'A problem with this approach is that many of these genes are highly correlated .', 'A main drawback of existing methods is that they rely on the simplifying assumption of a single causal variant at each risk locus , which is typically invalid at many risk loci .', 'A major methodological problem with this approach is that the cases and controls in these experiments are often born several generations apart .', 'A drawback of this method is that it can not be applied in situations when the data contains homoplasies ( multiple mutations of the same character ) or recombinations .', 'A problem with different methods that predict the effect of mutations is that they produce false positives .', 'However , a drawback of the case-only approach is that its conclusions may be biased by genotyping errors .', 'A major drawback of this approach is that it can not model the joint effect of a set of SNPs on a set of genes , which may correspond to biological pathways .']


Cluster  1849
['Even among advanced HF patients with high BNP level, an ET program significantly improved exercise capacity, and a greater improvement in exercise capacity was associated with greater decreases in BNP level and V̇E/V̇CO<sub>2</sub>slope and more favorable long-term clinical outcomes.', 'Physical activity and aerobic fitness is low in patients with FES.', 'For 24 mo postrehabilitation, 157 physically active subjects with PFP who reported treatment success were followed.', 'Compared with standard quadriceps strengthening, low load with BFR produced greater reduction in pain with daily living at 8 weeks in people with PFP.', 'To evaluate variables oxygen uptake (VO2) relative to lean body mass (LBM) and clinical symptomatology in women with FMS submitted to APT and after 16 weeks of detraining period, and to evaluate the association between the magnitude of VO2 improvement relative to LBM and clinical symptomatology.', 'Seventy-nine participants were randomly allocated to a standardised quadriceps strengthening (standard) or low-load BFR.', 'The findings support implementing a hip-or knee-muscle-strengthening program for the treatment of PFP.', 'Both taping and exercise groups showed significant improvements in HFD compared with the control group at post-treatment and follow-up.', 'Lokomat® training, in comparison with treadmill-plus training, does not provide further benefits in PSP patients undergoing MIRT.', "Upcoming maximal SB exercise tests, for evaluations in clinical settings, can't be considered as an evaluation of the maximal exercise capacity when compared to golden standard TM and UB."]


Cluster  1019
['P. aeruginosa continues to be a serious problem worldwide as a cause of respiratory tract infections in selected populations .', 'We outline why AMR is a serious endemic problem manifested in hospital and community-acquired infections .', 'Nosocomial MDR ABC infection is a serious concern in pediatric patients .', 'In Japan , MDR P. aeruginosa is becoming a serious problem in the clinical setting .', 'Bacterial brain abscesses remain a serious central nervous system problem despite advances in neurosurgical , neuroimaging , and microbiological techniques and the availability of new antibiotics .', 'Although it is uncommon , pediatric brain abscess remains a serious , life-threatening neurological problem .']


Cluster  1470
['A small but statistically significant decline was shown over time in the number of days with headache (HA), the number of days with HA with intensity ≥5/10, and the number of days with use of acute medication after 3\xa0months (p\xa0<\xa00.', 'Cluster headache, in a large cohort of Greek patients, has the same phenotypic characteristics as described internationally.', "Headaches are a serious public health concern of our days , affecting about 50 % of the world 's adult population .", 'Headache disorders are considered one of the ten most disabling conditions, for both males and females, according to the World Health Organization.', 'Red flags in children who present with headache -- how to recognize a serious problem .', '10 % to 30 % of all children worldwide suffer from headaches at least once a week , potentially constituting a serious health problem that may lead to impairment in multiple areas .', 'Sinus headaches are usually severely disabling migraines , misdiagnosed and mistreated , with 61 % of patients receiving antibiotic prescriptions for noninfectious causes , thus failing the patients and , in addition , contributing to a serious public health problem .', 'Two hundred patients (176 women and 24 men, mean age 40 years old) were included and classified according to headache frequency.', 'This single-center and retrospective study was conducted in a tertiary care specialist headache center in France.']


Cluster  788
['A low-intensity CBT-based music group can be successfully administered to clients of community mental health services.', 'Compared to a non-music control intervention, children and the therapist in MI spent more time in triadic engagement (between child, therapist, and activity) and produced greater movement, with amplitude of motion closely linked to the type of musical instrument.', 'Taken together, these findings provide initial evidence of the active ingredients of music-based interventions in autism.', "Music therapy is a non-pharmacological, inexpensive, and non-invasive technique that can significantly enhance patient satisfaction and decrease patients' embarrassing experiences related to perioperative stress, pain, and awareness.", 'There is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective.', 'The effectiveness of music-based interventions (MI) in autism has been attested for decades.', 'Music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support.', 'Here, we examined whether two processes, joint engagement and movement, which have previously been studied in isolation, contribute as important active ingredients for the efficacy of music-based interventions.', 'Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons.', 'musical stimulation is effective in significantly improving LOC among hospitalized patients with HT.', 'Dance may be an important nonpharmacological approach that can benefit cognitive functions.']


Cluster  1021
['This prospective observational cohort study included 136 children undergoing surgery at a tertiary pediatric hospital in Zimbabwe.', 'In a prospective trial, 60 noncooperative children of ASA I, II aged 3-10 years who underwent dental rehabilitation under general anesthesia were randomly divided into two groups.', 'Children with an ASA physical state classification of I or II, aged from 4 to 16 years and scheduled for elective circumcision or inguinal hernia repair under combined general and caudal anaesthesia were included.', 'This retrospective study is conducted by analysing the medical records of the patients who were operated for MD in the last 12 years in paediatric surgery department at our hospital.', 'From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18\xa0years, ASA\xa0I-III, undergoing elective procedures (ENT and pediatric surgery), were observed.', 'A prospective, randomized double-blinded comparative study conducted on sixty-six children (two groups of 33 each) between the ages of 3-10 years undergoing different elective surgeries.', 'We reviewed the medical records of patients below 3 years of age who underwent surgery between September 2013 and December 2016.']


Cluster  312
['To further elucidate the usefulness of patch tests in revealing the causative drugs of cutaneous ADRs (CADRs).', 'Study of ADR monitoring of outpatient and inpatient was a prospective and observational study carried out between September 2015 and August 2016.', 'ADAs are common in healthy subjects after a single intravenous dose of infliximab and result in faster infliximab clearance, shorter elimination time, and lower serum infliximab levels.', 'The study enables to obtain information on the incidence and pattern of ADRs associated with various antiretroviral regimens, thereby reducing its occurrence and protecting the patient population from avoidable harm.', 'This study analyzed the pharmacokinetic effect of infliximab ADAs in healthy subjects receiving a single dose of intravenous infliximab.']


Cluster  1951
['Our results, in contrast with previous studies, showed adequate health literacy levels of caregivers.', 'A majority of individuals displayed acceptable levels of health literacy, regardless of whether they chose to participate or not.', 'The majority of individuals, whether they were participants or non-participants in the SCREESCO program, had an acceptable level of health literacy and no significant differences in health literacy levels between the groups were found.', 'To assess the levels of health literacy of Italian caregivers of patients with heart failure.']


Cluster  251
['We conducted a PRISMA-compliant meta-analysis to systematically assess the prognostic value of LMR in patients with non-metastatic RCC.', 'Tumor APJ can be used to predict the therapy response and prognosis in GC patients receiving CRT+endostar therapy.', 'In summary, baseline CEA, number of metastatic sites, and age are strong independent prognostic factors for survival.', 'Traditional CRS are not a prognostic predictive tool when applied to patients receiving neoadjuvant chemotherapy for CRLM.', 'Endoscopy based evaluation of primary lesions are clearly associated with prognosis in patients with GC who perform chemotherapy.', 'This particularly is a serious problem in patients with high-risk NMIBC who are at high risk for failure of local treatment and thus candidates for early radical cystectomy or even systemic ( neoadjuvant ) chemotherapy .', 'In the eighth edition of the TNM classification of clinical-T1a-cN0M0 NSCLC, the prognosis of part-solid and pure-solid tumors showed no significant differences.', 'SBRT offers more favourable survival than no treatment for patients with localized NSCLC.', 'At the end of the study, we found a marked clinical improvement in all patients, associated to a statistically significant reduction of the proliferation index Ki67/MIB1.', 'The current analysis was performed to evaluate the prognostic value of disease and patient characteristics (age, number of metastatic sites, stage of primary tumor, performance status, carcinoembryonic antigen (CEA)) and on-treatment changes of CEA (response after 8-12 weeks of treatment and specific patterns of CEA kinetics) in patients from an observational cohort study of chemotherapy with bevacizumab.', 'Patients with NSCLC were considered eligible for nivolumab treatment after one or more lines of chemotherapy, and when in reasonable performance status (PS) [Eastern Cooperative Oncology Group (ECOG)\u2009<\u20093].', 'Although relapse-free survival (RFS) was significantly shorter in the pure-solid tumor group (<i>p</i>\u2009=\u20090.', 'This study supports the notion that the achievement of CR of RC and SLM should be the goal of oncological treatment.', 'Repeat CRS is oncologically beneficial, and the morbidity rate was as high as that of initial CRS.', 'EFS in patients with other diagnoses than Ewing sarcoma treated according to EE99 was significantly higher in patients with localized than metastatic disease.', 'Hyperprolactinemia in mNSCLC patients treated with NIVO could potentially represent a negative early predictive factor for poor clinical outcomes, thus anticipating PD shown by CT scan.']


Cluster  1804
["High noise levels have been recognized as a serious problem in hospital environments during both night- and daytime , and have been associated with a negative impact on patients ' health status .", 'Noise-induced hearing loss ( NIHL ) is a serious health concern and prevention of hair cell death or therapeutic intervention at the early stage of NIHL is critical to preserve hearing .', "Since noise was first recognized as a serious environmental pollutant , a number of social surveys have been conducted in order to assess the magnitude of the problem and to develop suitable noise ratings , such that , from a measurement of certain physical characteristics of community noise , one could reliably predict the community 's subjective response to the noise .", 'Noise-induced hearing loss ( NIHL ) caused by exposure to high noise levels is a serious socio-economic problem in modern societies .', 'Excessive noise exposure is a serious global urban health problem , adversely affecting millions of people .', 'Noise induced hearing loss ( NIHL ) remains as a severe health problem worldwide .', 'Sleep disturbance induced by night-time noise is a serious environmental problem that can cause adverse health effects , such as hypertension and ischemic heart disease .', 'Exposure to continuous loud noise is a serious health problem due to excess production of oxygen free radicals .', 'The comparative contribution to human noise exposure from the vehicular radio is unknown, as are the radio volume preferences of different generations when driving an automobile']


Cluster  1240
['The problem with these representation forms is that they are static', 'In the tablebased approaches , if a tokenized form is mapped to more than one surface form , we use the most frequent surface form . their inevitable dependency on the here-and-now', 'In the tablebased approaches , if a tokenized form is mapped to more than one surface form , we use the most frequent surface form . their inevitable dependency on the here-and-now']


Cluster  1299
['Bacteremia is often a serious and recurring problem in children with hemodialysis catheters .', 'Catheter-related bacteriuria is a serious problem of elderly patients residing in nursing homes and extended care facilities .', 'Sepsis from central triple-lumen catheters remains a serious and life-threatening problem .', 'Microbial colonization of urinary catheters remains a serious problem for medicine as it often leads to biofilm formation and infection .', 'Physicians who treat neonates who become bacteremic while dependent on central venous catheters face a serious and common dilemma .', 'Between October 2013 and August 2014, we prospectively enrolled 20 patients with catheter-related bloodstream infections (CRBSIs) or central line-associated bloodstream infections (CLABSIs) in our sister institutions in three countries including Brazil, Lebanon, and Japan.', 'Catheter-related bloodstream infections are a serious problem .', 'Catheter infection continues to be a serious problem in critically ill patients .']


Cluster  1856
["132 out of 214 (62%) children had three technically adequate nights' oximetry, including 13 out of 30 (43%) children with Down syndrome.", 'There is substantial night-to-night variation in overnight oximetry readings among children in all clinical groups undergoing overnight oximetry.', 'This retrospective observational study evaluated night-to-night variation using statistical measures of repeatability for 214 children referred to a paediatric respiratory clinic, who required overnight oximetry measurements.']


Cluster  1397
['A comparison of the two methods of corticosteroid (triamcinolone) use in reducing supratip edema (pollybeak deformity) after rhinoplasty.', 'Controlled intraoperative CSF drainage significantly reduces the incidence of intraoperative CSF leakage in patients undergoing endoscopic transsphenoidal surgery for pituitary adenomas.', 'To compare the efficacy and safety of adjunctive TachoSil (Takeda Pharma A/S, Roskilde, Denmark) with current practice for the prevention of postoperative CSF leaks in patients undergoing elective skull base surgery involving dura mater closure.', 'In conclusion, ventilation mode does not influence intraoperative bleeding during transsphenoidal pituitary surgery.']


Cluster  276
['Neutrophil count, NLR, and troponin I levels were significantly higher in the PA negative group.', 'AVP and copeptin levels were markedly elevated on admission, but decreased rapidly over time (p\xa0<\xa00.', 'MHR were significantly positively correlated with neutrophil to lymphocyte ratio (r=0.', 'Average CD8+and CD4+ cell counts co-expressing CD3 were 126.', 'Among SPKTRs, female sex, low BMI, CMV seronegativity, CMV disease, and acute cellular rejection increased the risk for sepsis (P < .', 'Compared with asymptomatic controls baseline production of all chemokines was significantly elevated in acute (P=0.', 'Since IL-21 is elevated non-specifically in this cohort, our data supports that IL-21 is not an appropriate biomarker for diagnosis of KD in North American pediatric populations.', 'Our study shows that IL-21 levels were non-specifically elevated across all febrile children, irrespective of KD diagnosis.', 'In peripheral blood, C-C motif chemokine receptor 9 [CCR9] gene expression demonstrated a dose-dependent increase relative to placebo, but in inflamed intestinal biopsies CCR9 gene expression decreased with increasing PF-00547659 dose.', 'Serum IL-33 concentrations were significantly higher in patients than in controls.', 'Differences in incidence, site, causative pathogens, and onset of sepsis between SPKTRs and KTRs may be attributed to more intense immunosuppression, major surgery, and complications of diabetes among SPKTRs.', 'Although lamellar mRNA concentrations of multiple inflammatory mediators (IL-1β, IL-6, CXCL1, MCP2, COX-2) were increased after OF administration (OF AMB group versus CON AMB; P\xa0<\xa00.', 'Serum cyclophilin A concentrations were significantly higher in patients than in controls.']


Cluster  2192
['Acquired immunodeficiency syndrome ( AIDS ) has emerged as a serious health problem in India .', 'Acquired immunodeficiency syndrome ( AIDS ) is a serious health problem worldwide .', 'Acquired Immunodeficiency Syndrome ( AIDS ) , caused by the Human Immunodeficiency Virus ( HIV ) , is a life-threatening disorder that persists worldwide as a severe health problem .', "The acquired immunodeficiency syndrome ( AIDS ) , caused by the human immunodeficiency virus ( HIV ) , has become a serious world-wide problem because of this disease 's rapid propagation and incurability .", 'As a kind of widely distributed disease in China , acquired immune deficiency syndrome ( AIDS ) has been quickly growing each year , become a serious problem and caused serious damage to the life and health of people and the social events of China and the world because of its high fatality rate .', 'Acquired immunodeficiency syndrome ( AIDS ) is a serious illness and a public health crisis that merits the concern of everyone .']


Cluster  1100
['End stage renal disease patients is a serious problem all around the world .', 'End-stage renal disease ( ESRD ) is a serious public health problem in Guangxi , a province of south China .', 'End-stage renal disease ( ESRD ) is a severe health concern over the world .', 'End-stage renal disease is a troublesome health problem worldwide .', 'DIN accounts for 18 - 27 % of community- and hospital-acquired episodes of acute kidney injury ( AKI ) and is a serious concern during development of novel therapeutic drugs .', 'End-stage renal disease ( ESRD ) is a devastating medical , social , and economic problem .', 'End-stage renal disease ( ESRD ) is a serious health problem worldwide .', 'DN is a serious public health concern because it is the leading cause of end stage renal disease ( ESRD ) in most developed countries and is associated with increased cardiovascular mortality and morbidity .', 'The number of patients with end-stage renal disease ( ESRD ) has been increasing , with dialysis treatment being a serious economic problem .', 'These markers are also elevated in end-stage renal disease ( ESRD ) , which constitutes a serious public health problem .']


Cluster  780
['DRI increased the visibility of the EVs and RCS.', 'We are indebted to ETS for sharing their data with us , and supporting us through this project . RI gives equal weight to FPs and FNs', 'A limited multielement capability is often cited as an important drawback of ETV-ICPMS .', 'A drawback of this layout is its visual clutter for multichannel EEG .', 'An equal-allocation, two-arm cluster RCT design was used.', 'With growing risk profile, there is a marked reduction of the rank value of ANSI, quantified individually by the radar plot area.', 'However , although the EMD-based filtering procedure has advantages such as a high SNR , suitable waveform shape , and high statistical power , one fundamental drawback of the procedure is that it requires the selection of an IMF ( or a partial sum of a range of IMFs ) to determine an ERP component effectively .']


Cluster  1848
['In a transfer-based MT system this means that the mode part will be interlingual , whereas the transfer rules will cater for the localizer . there are many more negative than positive examples', 'In a transfer-based MT system this means that the mode part will be interlingual , whereas the transfer rules will cater for the localizer . there are many more negative than positive examples', 'In a transfer-based MT system this means that the mode part will be interlingual , whereas the transfer rules will cater for the localizer . there are many more negative than positive examples']


Cluster  1452
['The average follow up period was 43.', 'Median follow-up time was 71.', 'The overall median follow-up time was 80.', 'After an average follow-up period of 7.', 'At 5-year follow-up, 9.', 'Patients were followed up for an average of 55.', 'The average follow-up period was 33 months (range, 14 to 80 months).', 'Mean follow-up time was 50\xa0months.', 'During the 30-day follow-up, 328 (4.', 'Of the 252 children included and randomized, 216 were followed-up after 2 years (14.', 'Follow-up at 2/24 months was 120,909/11,014 for the modeling group and 41,528/3703 for validation.', 'Mean follow-up was 192 days (IQR=77-285).', 'Median follow-up was 42 (1-109) months.']


Cluster  1644
['Peritonitis is a serious problem in children receiving peritoneal dialysis .', 'Peritonitis is a serious and common problem in the peritoneal dialysis ( PD ) population .', 'Peritonitis is still a serious problem in peritoneal dialysis ( PD ) patients and is associated with mortality .', 'Catheter-related infections remain a serious problem for patients on peritoneal dialysis .', 'Peritonitis remains a serious problem in peritoneal dialysis patients accounting for technique failure and contributing to mortality .', 'Susceptibility to bacterial infections in the peritoneal cavity is a serious problem for peritoneal dialysis patients .', 'A major drawback of continuous ambulatory peritoneal dialysis ( CAPD ) is the occurrence of peritoneal infection .']


Cluster  2253
['Alcohol misuse amongst University students is a serious concern , and research has started to investigate the feasibility of using e-health interventions .', 'Heavy episodic drinking ( HED ) is a serious problem among college women at high-risk for developing eating disorders ( EDs ) .', 'Binge drinking is a serious problem on many college campuses .', 'Alcohol abuse is a serious problem among college students , and drinking games are a common , yet risky practice in this population .', 'Alcohol use among university students is a serious public health concern , particularly among minority students who may use alcohol to cope with experiences of racial discrimination .', 'Alcohol abuse is a serious problem for students on college campuses .', 'Heavy drinking and associated negative consequences remain a serious problem among college students .', 'Climate, Preventure and CAP students demonstrated significantly lower growth in their likelihood to drink and binge drink, relative to controls over 24 months.', 'College drinking is a serious health concern .', 'There is considerable evidence that heavy episodic drinking ( HED ) is a serious problem among college students .', 'Excessive drinking among college students is a serious and pervasive public health problem .', 'Alcohol use/misuse is a costly public health problem, particularly among college students in the United States']


Cluster  1187
['The results showed that the infected subjects more often concealed their homosexuality , engaged in more risky sexual behavior and were less inclined to regard AIDS as a serious problem .', 'The students showed satisfactory knowledge , and AIDS epidemics was a serious issue and of concern to them , but many of the students who had experience with sexual intercourse seldom use condom on a consistent basis .', 'Results showed that AIDS was perceived as a serious social problem in the township , but was perceived as less serious than crime and not different from violence and unemployment .', 'Although AIDS epidemic was not a serious issue of concern to a substantial number of the students , they were knowledgeable on AIDS , and their perceptions on AIDS epidemics influenced their sexual practices .', 'Overall , the students showed satisfactory knowledge , and AIDS epidemics was a serious issue to 80 % of them , and of concern to 60 % of them , while 49 % of those who had experience with sexual intercourse seldom use condom on a consistent basis .']


Cluster  1469
['A Velcro® adjustable compression wrap (Circaid Juxtalite®) is efficient in reducing stasis edema in the elderly.', 'In all, 61\xa0healthy participants wore padded bandages foam or synthetic cotton wool on one leg and nonpadded bandages on the other.', 'The authors have tested a treatment protocol in 30 patients to quantify the reduction of volume caused by an adjustable compression Velcro® wrap (Circaid Juxtalite®, medi GmbH, Bayreuth, Germany) after 15 days and to compare its effect on the leg volume for the next 15 days with 15- to 20-mmHg compression stockings (CS).', 'Padded compression bandages maintain the therapy-relevant pressure better, provide more comfort, and cause less pain and skin problems than nonpadded compression bandages.', 'In a randomized controlled pilot study, 44 patients were allocated to a graduated medical elastic thigh compression stocking or standard treatment for 14 days after total knee arthroplasty.']


Cluster  1566
['A drawback of extensive coxib use for antitumor purposes is the risk of life-threatening side effects that are thought to be a class effect and probably due to the resulting imbalance of eicosanoid levels .', 'Gastric toxicity remains a serious problem with the current drugs , however .', 'However , the systemic toxicity of the anticancer drugs is still a serious problem .', 'One problem with these studies may be that the degree of dose escalation is not sufficient to result in an improved outcome because the chemotherapy doses are limited by hematopoietic toxicity .', 'Toxicity is a common drawback of newly designed chemotherapeutic agents .', 'The problem with these drugs is that long-term immunosuppression may be complicated by severe side effects including a major risk for cancer .', 'A few patients respond poorly to these drugs , and others need such high doses to control the disease that side-effects become a serious problem .', 'Side effects from targeted drugs remain a serious concern .', "A phase I study was conducted in cancer patients according to a new design following the recommendations of our Institution 's ethical committee to avoid the major drawback of classical phase I studies in which many patients receive the experimental drug at doses far under the potentially active dose extrapolated from experimental studies .", 'Although toxicity remains a serious concern when powerful immune modulators and antimetabolites are used in combination , relatively few serious adverse events have been reported during 2-year treatment periods .', 'Late-onset ( LO ) toxicities are a serious concern in many phase I trials .', 'However , drug toxicities have been a serious problem in patients after long-term administration .', 'However , they had low in vivo antitumor activities and high in vivo toxicities , which was a serious problem .', 'However , clinical activity in solid tumors has been disappointing and toxicity has been a serious concern ( Lamers et \xa0 al. , 2013 ; Morgan et \xa0 al. , 2010 ) .']


Cluster  489
['Physician retention is a serious concern to have an effective and efficient health system ; the key challenge is how best to encourage and retain health providers in their work location .', 'There is general agreement within pathology that there is a serious problem in the recruitment of US medical graduates into the field .', 'Shortage of pathologists in Canada : crisis or just a serious problem ?', 'Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands', 'The shortage of physicians in Japan is a serious concern , particularly in specialties like pediatrics .', 'The result of this policy is a serious shortage of doctors in Japan today , which has become a social problem in recent years .', 'Geographical maldistribution of physicians , and their subsequent shortage in rural areas , has been a serious problem in Japan and in other countries .', 'A vexing problem in health policy is getting the right number of physicians in the right specialties in the right locations at the right time .', 'There is no doubt that the healthcare environment provides a complex and frustrating working climate for the most dedicated professional employee , and the cost of absenteeism and turnover is a serious problem for healthcare administrators .', 'There is a serious concern that the pipeline for the production of the physician workforce is inadequate to meet future needs .']


Cluster  1639
['Water shortage is a serious problem in many small island states , and many depend heavily on rainwater as the source of their water .', 'With acceleration of urbanization , water shortages will become a serious problem .', 'Opportunities for water saving in maize systems exist , but water scarcity in China remains a serious problem .', 'The scarceness of freshwater assets is a serious problem in semi-arid zones and marginal quality water is increasingly being used in agriculture .', 'Water scarcity has become a serious problem in many parts of the world .', 'Global increase in water scarcity is a serious problem for sustaining crop productivity .', 'The inability of the Government to budget and prioritise its budget poses a serious problem to meet the water demand , a few residents in peri-urban settlements use other sources of water , including groundwater .', 'The scarcity of water is a serious concern for food security of these countries and climate change has aggravated the risks of extreme events like drought .', 'Shortage of freshwater is a serious problem in many regions worldwide , and is expected to become even more urgent over the next decades as a result of increased demand for food production and adverse effects of climate change .', 'The amounts of total, freezable and unfreezable water were determined.']


Cluster  484
['Another drawback is that it is impossible to adapt them to a specific task , which could generate many errors that are important to the task', 'The most significant drawback is that ontologies are not standard among systems', 'A possible drawback of this approach is the lack of structure in these networks .', 'Furthermore , it always holds a drawback of writing color buffers multi-times per frame .', '. they require a great deal of skilled hand-crafting that , unfortunately , usually does not scale in broader application domains', 'This is a serious limitation of various attempts to circumvent this problem .', 'This constraint poses a serious problem for network modeling , namely , the compatibility between robustness and efficiency .', 'An additional drawback is that all existing systems can be used for analysis but not for generation', 'The main limitation is that the quality of the output is very susceptible to the quality and amount of resources available', 'A major drawback of such approaches is that they do not scale well .', 'A main drawback of these knowledge-based systems is the knowledge representation formalisms they use .']


Cluster  2254
['The more severe the vestibular symptoms, the better the outcome of surgical therapy.', 'In addition , vestibular dysfunction is associated with chronic pain , which could present a serious public health concern as approximately 43 % of US adults have chronic pain .', 'Healthy controls with no history of otologic or neurologic disorders (n\u2009=\u2009291) were compared to patients with known vestibular disorders (n\u2009=\u200962).']


Cluster  865
["Infants born at <28 weeks' gestation were enrolled in this study.", 'As part of the evaluation of the Helping Babies Breathe intervention, direct observations of labor and delivery were conducted in August 2013 from 27 out of the 28 districts in Malawi.', 'Retrospective study involving preterm infants less than 32 weeks gestational age and/or weight less tan 1,500 g born between january 2012 and december 2014.', 'Ninety-six preterm infants (41 male), aged 33.', 'A prospective observational study was performed in which all infants born between January and August 2008, at Sheba Medical Center at 34 0/7-35 6/7 weeks of gestational age were included.', 'In this randomized controlled trial, 40 infants with a gestational age at birth of less than 32 weeks were recruited.', 'This is a prospective observational study including consecutively admitted preterm infants with a gestational age <32 weeks.', 'A convenience sample of 30 infants with a mean gestational age of 25.', 'Results from the present study suggest that a single osteopathic intervention may induce beneficial effects on preterm physiological parameters.', "This was a prospective observational study conducted at a single center, involving children <5\xa0years age, born preterm (GA <30\xa0weeks) or at term (≥37\xa0weeks' GA).", 'We implemented the phase III RTS,S/AS01 trial at the Malawi site, which enrolled 1578 infants (6-12\u2009weeks) and children (5-17\u2009months) living in the Lilongwe District in Central Malawi and followed them for 3\u2009years between 2009 and 2014.', 'A case-control study was conducted in Omdurman Maternity Hospital, Sudan, during the period of September through December 2014.', 'A prospective Longitudinal study Department of perinatology of performed Emam Khomeini hospital and Mirza Kochak Khan Hospital in Tehran, Iran from March 2013 to January 2014.']


Cluster  2232
['Thus , attrition continues to be a serious problem for naltrexone maintenance , although further efforts to develop interventions such as BNT are warranted .', 'Loss of clinical effects , despite adequate compliance , has also emerged as a vexing clinical problem .', 'Patient adherence to medication or lifestyle interventions is a serious concern .', 'However , poor long-term adherence is a serious problem affecting the therapeutic effect of this mature treatment .', 'Finally , disease relapse is a serious problem ( 20 % in our group ) , which stresses the importance of standardized follow-up programs .', 'However , recent reports on its declining efficacy and increasing relapse rates pose a serious concern .', 'Treatment resistance remains a serious psychiatric problem .', 'However , resistance to such therapy is a serious clinical problem .']


Cluster  2214
['IgA pemphigus is a rare autoimmune vesiculo-pustular skin disease', 'Treatment of benign familial pemphigus or Hailey-Hailey disease (HHD), a rare inherited condition associated with a significant impairment of quality of life, is often challenging and disappointing with frequent relapses and infectious complications.', 'This prospective observational study included 80 consecutive patients with histopathologically and immunopathologically confirmed pemphigus, of whom 11 (13.', 'To evaluate the clinical and immunological characteristics of patients with pemphigus-associated alopecia.']


Cluster  1499
['Oral isotretinoin showed better and earlier response than topical isotretinoin.', 'These findings may indicate that the occurrence of hypertrophic scars or keloids in patients using oral isotretinoin is an undesirable event arising from an individual response and may be related to inflammatory acne evolution.', 'The combination of NAFL with low-dose isotretinoin is a safe and effective treatment for moderate-to-severe acne.', 'This study was designed to determine the efficacy and safety of low-dose oral isotretinoin in the treatment of moderate to severe seborrhea and seborrheic dermatitis on the scalp and/or face.', 'Oral Isotretinoin (13-cis-retinoic acid) is a gold standardtreatment for severe forms of acne with cheilitis as a most frequent complication.', 'Eighteen patients who received 10-mg oral isotretinoin per day completed 3 sessions of NAFL treatment on one half of the face and presented for each scheduled follow-up appointment.', 'To investigate the clinical efficacy and safety of performing NAFL treatment in patients with moderate-to-severe acne vulgaris under treatment with low-dose oral isotretinoin.', 'The aim of this study was to investigate the prevalences of hypertrophic scars and keloids in acne patients treated with oral isotretinoin.']


Cluster  1416
['The re-use rate is determined by the number of rules in which a particular symbol occurs , which is actually very high -LRB- more than 1000 on average -RRB- . data sparseness', 'The re-use rate is determined by the number of rules in which a particular symbol occurs , which is actually very high -LRB- more than 1000 on average -RRB- . data sparseness']


Cluster  317
['Burnout, depression, and suicide among health care professionals and learners have reached a rampant level', 'Burnout among hospital-based nurses appears to be a serious problem affecting the delivery of health care .', 'Physician burnout is a serious concern for hospital leaders .', 'Burnout is a serious problem for critical care unit workers because they are exposed to chronic psychosocial stressors , including high responsibility , advanced technology and high patient acuity .', 'Nurses burnout is a serious problem which can affect their health , the quality of patient care , and health institutions .', 'Nurse fatigue is a serious problem with negative consequences on patient safety and nurse well-being .', 'Burnout is a serious problem that anesthesiologists face during training and in practice .', 'Burnout is a serious concern in graduate medical education . While enhancing resilience in trainees is considered beneficial , there are few studies showing successful interventions .', 'Physician burnout : a serious concern for the medical profession .', 'Burnout is a serious problem among nursing staff internationally with negative impacts on the quality of care and patient safety .', 'Burnout is a serious problem for psychiatrists that has implications for clinical practice and personal health .', 'Purpose Physician stress and burnout is a serious and common concern in healthcare , with over half of physicians in the USA meeting at least one criterion for burnout .', 'Occupational burnout is both a serious public and individual health concern .', 'Burnout is a serious problem for health care providers that has implications for clinical practice and personal health .', 'Nowadays , the professional burnout of paramedical personnel becomes a serious health care problem , resulting in productivity loss and medical care costs increase .', 'Stress and burnout among general practitioners ( GPs ) is a serious problem .']


Cluster  1310
['Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory.', 'By intervention, the catheter gradient was significantly reduced from 21.', 'The purpose of this study was to investigate the safety of clinically indicated peripheral intravenous catheters (PIVC) replacement intervals.', 'To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance.', 'To investigate the effect of using a single guiding catheter (MAC 3.', 'Overall, both education and the timing device interventions increased the mean scrub time ± SD of venous catheter hubs.', 'A prospective randomized controlled trial was conducted among 446 patients who planned for transradial cardiac catheterization.', 'Results added knowledge on use of midline catheters (MCs) for blood sampling.', 'Clinically, 1034 CRBSIs were observed in 548 adults receiving HPN for 1410 catheter-years.', 'Although some differences in specific baseline characteristics, such as body size and pacing indication, and in implant procedure characteristics, including anticoagulation strategy and hospitalization period, were observed in the Japanese patients, transcatheter pacemaker performance was similar to that in the global trial.', 'For many patients with a long-term indwelling catheter , encrustations can be a severe problem .', 'It is our experience that the use of catehters in patients requiring short/medium- term PN is a safe procedure with few complications ; patients on home long-term PN present an increasing number of complications , and the vascular access could become a serious problem as the number of PN-dependent increases .', 'The stabilization of a guide catheter is an important factor for performing successful neurointerventional procedures', 'A total of 218 catheters were sampled, with a median catheter lifespan of 2·0\xa0days.', 'The trial was conducted in Egypt where the use of non-tunneled temporary catheters is prevalent compared to tunneled long-term catheters.']


Cluster  846
['Immmunosuppression and infectious disease in cancer patients receiving chemotherapy is a serious problem .', 'Thirty-four previously untreated patients with oat cell carcinoma of the lung were treated with a myelotoxic combination of cyclophosphamide , adriamycin , methotrexate , CCNU , and Corynebacterium parvum ( regimen A ) every 4 weeks , interspersed with a non-myelotoxic combination including bleomycin , vincristine , dehydroemetine , and Corynebacterium parvum ( regimen B ) weekly the other 3 weeks or when hematologic toxicity prohibited administration of regimen A. Hematologic toxicity was frequent but was never a serious problem except in two cases of profound leukopenia in which fatal supervening infection occurred .', 'Chemotherapy toxicity is a serious problem from which non-small cell lung cancer ( NSCLC ) patients suffer .', 'Despite recent improvements in supportive care , treatment-related death ( TRD ) remains a serious problem for lung cancer patients undergoing systemic chemotherapy .', 'Infection in those treated by CAPD was a serious problem and may be exacerbated by aggressive chemotherapy .', 'CDI may remain undetected in patients undergoing chemotherapy even in those who had not received antibiotic treatment previously, unless due attention is paid to its possibility.']


Cluster  1780
['Postnatal depression correlates with postpartum weight retention, and dysregulated cortisol metabolism is evident in depressed individuals.', 'Greatest weight loss in the postpartum year was associated with lower conversion of cortisone to cortisol and lower conversion of cortisol to its metabolites, supporting previous work that demonstrates the facilitative role of lower 5α-reductase and 11β-HSD-1 in weight loss.', 'Low 5α-reductase activity was associated with greater weight loss across the first year, independent of demographics, breastfeeding and depression.']


Cluster  1138
['A total of 400 unrelated healthy Thais, 261 Burmese and 249 Karen was included in this study.', 'This cluster-randomized controlled trial was carried out in 196 classes of 61 schools, with a total of 4163 participants with a mean age of 15.', 'A cluster quasi-randomised controlled trial was conducted across 8 schools, including 1124 girls, in rural Uganda.', 'Pilot study of a randomized, parallel two-arm, triple-blind clinical controlled trial in 150 adolescents and young adults in the city of Bucaramanga-Colombia.', 'This randomized controlled trial included 120 Somali-born parents with children aged 11 to 16 years.', 'This research comprised an experimental study employing a prospective, double-blind, randomized controlled trial among 57 Thai participants divided in 2 groups (29 for the experimental and 28 for the placebo groups).', 'Nine professional Muay Thai fighters participated in this randomized, cross-over trial.', 'This was a parallel randomized controlled trial conducted in Egypt.', 'A randomized controlled trial was conducted in healthy 4-13-year-old Thai schoolchildren attending public school in central Thailand.']


Cluster  1935
['However , the major problem associated with most currently clinical available artificial bone substitutes ( scaffolds ) is that they mainly possess filling function but lack of osteo-induction abilities .', 'This RCT was aimed to evaluate complications rate and vertical bone gain after Guided Bone Regeneration (GBR) with dense non-resorbable d-PTFE titanium-reinforced membranes (Group A) versus titanium meshes covered by cross-linked collagen membranes (Group B).', 'A major drawback of electrospun scaffolds is the small interfibrillar pore size , which normally prevents cellular penetration in between fibers .', 'A major drawback of nanocomposite scaffolds in bone tissue engineering is dimensional shrinkage after the fabrication process .', 'However , a potential drawback of the bioresorbable scaffold is the potential for disruption of the strut network when overexpanded .', 'Electrospun collagen scaffolds are often fabricated and used as a tissue-engineered cornea , but the main drawback of poor mechanical properties make it unable to meet the requirement for surgery suture , which limits its clinical applications to a large extent .', 'These scaffolds have an advantage of highly interconnected porosity ( approximately 85 % ) but a drawback of poor mechanical strength .']


Cluster  1574
['Real-time quantitative PCR was employed to measure the expression level of miR-133b in tissues.', 'In this study, circulating plasma miRNAs did not emerge as promising biomarkers for iron status in healthy individuals.', 'The current investigation demonstrated that miR-133b level is useful for predicting the prognosis of patients with glioma.', 'In this study, we integrated the expression profiles of plasma miRNAs in these 3 subtypes, and assessed the distinct and overlapping dysregulated miRNAs using Venn diagrams.', 'After OHCA, miR-122-5p demonstrated a marked acute increase in plasma and was independently associated with lactate and bystander resuscitation.', 'The relative expression level of hsa-miR-221-3p in BC tissues was significantly higher than that in adjacent noncancerous breast biopsies (p ≤ 0.', 'Recently, microRNA-133b (miR-133b) dysregulation has been shown to play a key role in several human cancers, as well as glioma.']


Cluster  2137
['Echinococcal disease is still a serious problem in certain parts of the world .', 'Cystic echinococcosis ( CE ) , caused by Echinococcus granulosus metacestode , invokes a serious public health concern .', 'Echinococcosis continues to be a severe public health problem in this part of China because of unhygienic practices/habits and poor knowledge among the communities regarding this disease .', 'Cystic echinococcosis is a zoonotic disease with a wide geographical distribution , Greece included , and is considered to be a serious problem for the public health and the livestock economy .', 'Cystic echinococcosis due to Echinococcus granulosus is a serious public health and livestock economy problem in Libya .', 'Cystic echinococcosis due to Echinococcus granulosus is a serious public health and economic concern in India .', 'In Algeria , cystic echinococcosis ( CE ) is a serious economic and public health problem .', 'Cystic echinococcosis due to E. granulosus is a serious public health and livestock economy problem in Libya .', 'Echinococcosis is still a serious problem particularly in endemic areas such as South and Central America , Mediterranean countries , and Russia .', 'In the endemic countries , human cystic echinococcosis ( CE ) poses a serious medical and social problem .', 'The cystic echinococcosis described as a young adult disease may actually observed at any age and remains a serious problem of public health in Tunisia .', 'Cystic echinococcosis ( CE ) is a serious public health problem in sheep-raising regions of Turkey .', 'Childhood echinococcosis remains a serious health problem for the country .', 'Cystic echinococcosis , which is one of the most important helminthic infestations , is a serious life-threatening health problem in developing countries .', 'Alveolar echinococcus ( AE ) is a severe health problem in endemic areas .', 'Cystic echinococcosis ( CE ) caused by Echinococcus granulosus remains a serious problem worldwide for issues relating to public health and the economy .', 'The cestode Echinococcus multilocularis infection , a serious health problem worldwide , causes alveolar echinococcosis ( AE ) , a tumor-like disease predominantly located in the liver and able to spread to any organs .', 'Human cystic echinococcosis ( CE ) is a serious public health problem in West China .']


Cluster  191
['Twenty patients underwent EUS-HGS.', 'The results indicate that HC has a greater impact on DM management and health outcomes.', 'This study will provide proof regarding the therapeutic effect of JPHZXN among patients with MHE.', 'The study included 30 patients with POH.', 'RHD is still a serious health problem in Turkey .', 'For nonmalignant disease , the question arises of whether the higher incidence and severity of chronic GVHD is a drawback of this procedure .', 'Ocular chronic GvHD representing a severe ocular surface disease is a long-term problem after allogeneic HSCT .', 'To examine the long-term (42-47\u2009months) effects of the HET.', 'The cIMT values did not change significantly in the observation period in children with GHD (Δmaximum and Δmean cIMT 0.', 'Despite significant advances in medical technology and increased understanding of disease mechanisms , RHD continues to be a serious public health problem throughout the world , especially in low- and middle-income countries .', 'The evidence base for the ability of EHHMSs to reduce HCAIs needs to improve before NHS trusts will consider procuring them.', 'The study included 30 THR patients and 30 healthy subjects.', 'These data show that physician knowledge regarding the management of patients with RH is good.', 'Seventy-two patients with MHE are enrolled and allocated in a 1:1 ratio in an experimental group and a control group.', 'These findings suggest that cGVHD is a serious problem in pediatric UD-BMT .']


Cluster  1706
['In total, 22 917 patients (response rate 75·5 per cent) who had an elective unilateral groin hernia repair were analysed.', 'Simultaneous exploration and repair of the incidental defects on the contralateral inguinal region during laparoscopic TEP repair of unilateral inguinal hernia is recommended in selected patients based on its high safety and clinical effectiveness in preventing later CMIH.', '234 consecutive male patients with clinically unilateral and clinically bilateral hernia were enrolled; those with a clinically unilateral hernia were sent for groin US and if positive, a bilateral TEP groin hernia repair was performed (USBH).', 'The risk of significant pain 1\u2009year after groin hernia repair in routine surgical practice was 15·2 per cent.', 'Spinal anesthesia offers some advantages in patient analgesia during the early postoperative period after TAPP inguinal hernia repair and can be proposed as an effective alternative method of anesthesia for TAPP repair.', 'A single injection LAP blockade significantly reduces the post-operative analgesic requirements and provides longer pain relief compared with TAP block after laparoscopic inguinal herniorrhaphy.', 'This one blinded clinical trial study was conducted on 800 patients with indirect inguinal hernia.', 'Chronic groin pain after inguinal hernia repair , a serious problem , is caused by entrapment of the ilioinguinal nerve either by mesh or development of fibrosis .', 'To compare the results and complications between two conventional methods of pediatric inguinal herniotomy with and without incising external oblique aponeurosis in terms of recurrence of hernia and other complications.', 'The results of this study showed that in pediatric patients undergoing unilateral inguinal hernia repair or orchiopexy the quadratus lumborum block provided longer and more effective postoperative analgesia compared with the transversus abdominis plane block.', 'Seventy adult American Society of Anesthesiologists I, II and III patients undergoing elective TAPP inguinal hernia repair were randomized to either general or spinal anesthesia.', 'Fifty-three children undergoing unilateral inguinal hernia repair or orchiopexy surgery were randomized into 2 groups: transversus abdominis plane block and quadratus lumborum block.', 'Combined surgery for cesarean delivery and preperitoneal mesh repair for inguinal hernia has not been previously reported.', 'In this prospective randomized controlled study, 68 children with indirect inguinal hernia who underwent high ligation of hernia sac were randomly divided into 3 groups: high-pressure group (12\u200amm Hg, HP group, n\u200a=\u200a26); low-pressure group (8\u200amm Hg, LP group, n\u200a=\u200a20); open operation group (OP group, n\u200a=\u200a22).']


Cluster  1942
['Worldwide prevalence of OP is considered a serious public health concern .', 'Opisthorchiasis is a serious public health problem in East Asia and Europe .', 'Ochratoxin A ( OA ) is a toxic isocoumarin derivative released by various species of mold which grow on grain , coffee , and nuts , representing a serious worldwide health problem .', 'Occupational medicamentosa-like dermatitis induced by trichloroethylene ( OMLDT ) is a hypersensitivity disease with autoimmune liver injury , which has increasingly become a serious occupational health problem in China .']


Cluster  1569
['During the study period, TPN was initiated in 31 (25.', 'PPMI was required in 39.', 'Mean EA was 29.', 'PLE occurred in 24.', 'SCMMF was dissected in 30 (23.']


Cluster  1985
['The most commonly reported adverse event following vaccination was injection site pain.', 'Pain during the insertion of the needle and injection was less with IOA vs CIA in children.', 'Children experienced similar levels of pain in all sites of injection using the traditional method.', 'Pain scores during, one minute and two minutes after vaccination in group 1 were lower than in groups 2 and 3.']


Cluster  155
['The ratio of lesions in the thoracic area to lesions in the whole body decreased with age, whereas those of other areas increased.', 'Histopathologic examinations revealed 34 (25.', 'The cytologic changes reported here pose a serious diagnostic problem because they may be so severe as to mimic malignant transformation .', 'Although its histogenesis remains controversial , its histological characteristics are distinctive enough not to pose a serious problem for diagnosis .', 'Our study demonstrated a practical histologic approach to differentiate between intraepidermal pagetoid neoplasms.', 'The presence of a black or brown stoma may indicate a serious problem , such as a necrotic stoma , or may be the result of a benign pigmentation disorder known as melanosis coli .', 'The lesion had a worrisome clinical picture , its dark colour constituting a clinico-pathological diagnostic problem .', 'A diagnostic problem with atrophy and several of the benign proliferations is that the glands often have a discontinuous or absent basal cell layer .', 'The study included five males and one female aged 50 to 69 years who presented with a cutaneous mass in the face.', 'A retrospective observational study was performed and 70 Spitz nevi were analyzed using clinical and dermoscopic examination.', 'We aim to investigate dermoscopic features of acral nevi, age, and localisation-related findings of these lesions.']


Cluster  393
['The aim of this study was to identify the rate of early visual acuity poor responders in patients with neovascular age-related macular degeneration (AMD) after the first intravitreal injection of ranibizumab (Lucentis; Genentech, South San Francisco, CA) and to determine potential predictors for early response.', 'Age-related macular degeneration is a serious public health problem , and in most cases no cure exists .', 'The randomly selected study eye received a series of three IPL treatments that were applied directly on eyelids with an interval of 4 weeks (treatment energy, 14-16\u2009J/cm<sup>2</sup>).', 'The high prevalence of diabetic retinopathy observed in all major ethnic groups in Mauritius portends a serious public health problem , given the relative recency of the NIDDM epidemic in that country and the limited resources for laser photocoagulation .', 'In this observational clinical trial, different physicians performed panretinal photocoagulation for diabetic retinopathy.', 'Topical IU therapy is safe and effective for treating macular atrophy in AMD patients.', 'Diabetic retinopathy is a serious public health concern .', 'This randomized clinical trial was performed on women aged 28-62 years who complained of infra-orbital dark circles.', 'Age-related macular degeneration still remain a challenge for ophthalmologist and it also poses a serious social problem .', 'Patients with choroidal neovascularization secondary to AMD were evaluated before and 1 month after their first ranibizumab treatment.']


Cluster  1885
['During the protocol period, the highest grade AE (HGAE) in 555 visits was a grade 2 event or lower, in 212 visits it was a grade 3 event, in 1 visit it was a grade 4 event, and there were no grade 5 events.', 'A total of 198,339 primary LSG operations were included and grouped into No SLR (23.', 'Overall, respondents incorrectly answered 395 of 1008 questions (0.', 'There were 11 major pedicle perforations (Grade 2 or 3) by the 404 screws (2.', 'A total of 217 button press events were recorded (1.', '2,341 errors were detected during the 5 stages.']


Cluster  91
['Although level-set based segmentation techniques are frequently used in liver segmentation due to their flexibility to adapt to different problems by incorporating prior knowledge , the need to initialize the contours on each slice is a common drawback of such techniques .', 'Three different brain regions show ReHo changes in DON patients, and these changes could serve as diagnostic and/or prognostic biomarkers to further guide the prevention and treatment of DON patients.', 'These data may help pathologists and confocalists better define margins of LM.', 'LA remodeling in segmental and global MVP is considerably different regarding its association with MR volume or MV annular dilatation and its regional predominance.', 'The current state-of-the-art automatic ROI methods can be considered good alternatives for subjective and laborious manual segmentation in C-raclopride-PET studies.', '(1) Descriptive observational study comparing the centre, edge and surround of LM on histopathology and RCM; (2) retrospective cohort study comparing parameters associated with MR and non-recurrent (NR) LM.', 'We matched 22 patients with DON with 22 healthy controls (HCs).', 'ReHo values of the right middle frontal gyrus (RMFG), left anterior cingulate (LAC), and superior frontal gyrus (SFG)/left frontal superior orbital gyrus (LFSO) were significantly lower in DON patients compared to HCs.']


Cluster  1273
['A total of 30 patients were enrolled; 15 were assigned to LAP group and 15 to SP group.', 'Thirty-six patients were randomly assigned to SADBE (18 cases) or vehicle (18 cases) group.', 'A total of 110 GDM patients admitted to our hospital from April 2019 to April 2020 were selected and divided into 2 groups according to the random number table method, with 55 participants in each group.', 'Twenty-six patients were randomly assigned to Guided Surgery or Conventional Surgery.', 'Forty-four patients were randomly assigned to undergo either DM or US.', 'Of 89 people recruited, three chose to be randomised and 86 expressed a treatment preference (32 chose TAU, 34 chose TS, 23 chose HS).', 'The patients were randomly assigned into two groups, i.e. those receiving WRBCs (n = 21) and those receiving NWRBCs (n = 17).', 'Patients were randomly enrolled to an LRSB or control group (n=19 each).', 'Between June 2016 and February 2017, we randomly allocated a total of 78 patients: 39 patients to Flex 19G and 39 patients to 22G.', 'Twenty patients were randomly assigned to the flow group (n = 10) or the control group.', 'About 53 simple extractions were randomized to either laser or control group.', 'In this prospective, double-blind study, 100 adult patients were allocated randomly to 1 of 2 groups (each n\u200a=\u200a50).', 'Twenty-seven patients were assigned to the lavender group and 22 patients were assigned to the control group.', 'Ninety eligible patients were randomly allocated into two groups.', 'In this prospective randomized controlled study, patients were randomly assigned to either a TEAS group (n=37) or a control group (n=38).', 'Eighty patients were randomly assigned to the USS group or the Control (C) group.']


Cluster  1000
["Finally the authors emphasize the disease 's morbidity and characterize it as a serious and present problem of public health in Crato , Ceará .", 'In the state of Paraná , Brazil , loxoscelism is considered a serious public health problem , and Loxosceles intermedia Mello-Leitão ( Araneae : Sicariidae ) is associated with the majority of reported accidents .', 'To determine the incidence and early case-fatality from SICH in Algarve, the southernmost region of Portugal.', 'Thus a serious methodological dilemma results for the clinical aspect of environmental medicine .', 'Two investigational sites in Chile.', 'The data suggested that these men were afflicted with a severe occupational health problem , possibly scattered throughout a large area in northeastern Brazil , where manual pit excavations occur during the whole year and increase during drought periods .', 'Its incidence has increased in Brazil in recent years , representing a serious public and animal health problem .']


Cluster  1177
['The study confirms a serious public health problem in both countries , and documents that environmental exposure persists in subgroups of women , even in those who quit smoking .', 'Smoking is a serious medical and social problem in Poland .', 'Hungary has a serious problem , historically significant and currently of increasing size , partly due to changes in trafficking routes .', 'Drug abuse is a serious problem in Poland , it has expanded in recent years and it is likely to expand further in the years to come .', 'In Poland smoking poses a severe socioeconomic problem .', 'It is not only a severe health problem in Poland , but as well as in the whole world .', 'It appears that alcohol consumption will remain a serious problem in Czech society , therefore , more attention should be paid to this phenomenon in the future .']


Cluster  2333
['However , the instability of operation due to inherent filamentary randomness is a severe problem that is yet to be solved .', "The intercomparison also revealed a serious problem with one of the overlay plates of the HML 's phantom .", 'A catastrophic problem may occur when an imaging system suddenly fails .', 'It potentially represents a serious problem because of his unforeseeable evolution during the time :', 'A more troubling problem is the instability of the model']


Cluster  1001
['Fifty-six patients were selected for this prospective clinical study.', 'The clinical data in the present study derived from a previous trial (NCT00520247).', 'A total of 19 patients were studied in this phase 1 study.', 'Fifty patients were randomised, 41 analysed: 22 in arm A, 19 arm B. The overall R1 status was 61%, without significant differences between the two arms.', 'Twenty-three patients were studied; 21 (91%) had an INR of 1.', 'Results were analyzed in 16 patients of Group A and 13 patients of Group B. At the end of 3 months of therapy, 11 (69%) patients in Group A had complete remission whereas five (31%) had partial remission.', 'Two DBPTB patients (four percent) and nine 4SHS patients (17.', 'A total of 312 patients were investigated (AD/DLB = 241/71).', 'Twenty-three patients in the SB group and 25 patients in the AV group were followed for a minimum of 24months.', 'A clinical response was observed in 99/124 (79%) patients at 3 months and in 62/107 (61%) patients at 12 months.', 'In 46 patients (6.']


Cluster  1590
['Problem drinking is a serious public health problem in the workplace .', 'Work-related problems are a serious concern among persons with substance use but due to lack of a standardized tool to measure it ; these problems are neither systematically assessed nor appropriately addressed .', 'Drug use among employees continues to be a serious concern for American employers .', 'Research on drug use and the workplace is not extensive , and the effects of inhalant intoxication can be a serious problem in the workplace .', 'Substance abuse is a serious problem , because it affects both workers and young people .']


Cluster  1105
['Since there is a good correlation and agreement between basic and extended urine collections to study the mechanisms underlying urine production, the choice of urine sampling method to evaluate urine production depends on the purpose.', 'uFDP were measured using first urine in the morning (supine) and non-first urine during a hospital visit (upright) and then normalized to urine creatinine (uFDP/Cr, ng/mgCr).', 'A pseudorandomised controlled trial was undertaken with 240 female patients for whom urinalysis was clinically required.', 'Urinary 5α/5β metabolites in all pathways were strongly suppressed after the administration of DUT for one month and the pharmacological effect of DUT prolonged even after withdrawal of DUT.', 'Comparison of uFDP levels in supine/upright urine can be reliable for diagnosing OP and for differentiating it from active GN.', 'Urine and blood samples as well as clinical parameters were prospectively collected after the administration of DUT to 60 BPH patients, and after its withdrawal in another set of 25 BPH patients.', '80 patients eligible for urodynamic examination, 42 men and 38 women, have been prospectively enrolled in the study and randomised in two groups (A and B) of 40 individuals.']


Cluster  2107
['Nasal high flow oxygen appears effective in a selective group of ward patients with respiratory failure, or at risk of respiratory deterioration, and may reduce demand on critical care beds; this warrants further research.', 'This study evaluated the use of nasal high flow oxygen in adult ward patients with respiratory failure or at risk of respiratory deterioration.', 'Data and outcomes of pediatric patients receiving nasal high flow for upper airway procedures were analyzed.', 'Nasal high flow can be used in spontaneously breathing children with abnormal airways for maintenance of oxygenation during anesthesia for tubeless airway procedures.']


Cluster  804
['The limited simultaneous detection of multiple OS markers within one sample is a major drawback of these methodologies and can be addressed through the use of metabonomics .', 'A major drawback of executing genomic applications on cloud computing facilities is the lack of tools to predict which instance type is the most appropriate , often resulting in an over- or under- matching of resources .', 'Software containers greatly facilitate the deployment and reproducibility of scientific data analyses in various platforms', 'However , when used for the purpose of integrative analysis , a serious drawback of current ChIP-seq technique is that it is still expensive and time-consuming to generate ChIP-seq datasets of high standard .', 'The data deluge phenomenon is becoming a serious problem in most genomic centers .', 'A drawback of these approaches is that the necessary sequencing library preparation and bioinformatic analyses are complicated and continuously changing , which can be a barrier for researchers new to the field .', 'RNA sample contamination or swapping is a serious problem for downstream analysis and may result in false discovery and lose power to detect the true biological relationships .', 'As the Human Genome Project moves into its sequencing phase , a serious problem has arisen .']


Cluster  385
['tactic , lexical , as well as semantic levels . we only get to see a small subset of the examples that the experimenter has collected and our view is controlled by the opinions of an analyst , who typically was not a participant to the conversation and who might not even have been present at the time', 'An inherent difficulty of this approach for the reader is that we only get to see a small subset of the examples that the experimenter has collected and our view is controlled by the opinions of an analyst , who typically was not a participant to the conversation and who might not even have been present at the time', 'tactic , lexical , as well as semantic levels . we only get to see a small subset of the examples that the experimenter has collected and our view is controlled by the opinions of an analyst , who typically was not a participant to the conversation and who might not even have been present at the time', 'Other people have questioned whether there is any correspondence between what people do and what they say -LRB- Nisbett 4 Wilson , 1977 -RRB- . it relies too heavily on user interaction', 'Other people have questioned whether there is any correspondence between what people do and what they say -LRB- Nisbett 4 Wilson , 1977 -RRB- . it relies too heavily on user interaction']


Cluster  725
['Cholera , though a preventable and treatable disease , is still regarded as an important public health problem in developing countries including India .', 'In contrast with other locations, a prevalence of infections in children under 1 year of age in the city could be observed; this emphasizes the importance of epidemiological knowledge at the local level.', 'We acquired district level data on cholera case reports of 2010-2015 from the Integrated Disease Surveillance Program.', 'This observational study reviews data on the number of cases of yaws identified by each of the five yaws detection approaches: 1) passive yaws detection at local clinics after staff attended Neglected Tropical Disease awareness workshops, 2) community-based case detection carried out in remote communities by hospital staff who relied on community health workers to identify cases, 3) yaws screening following mass Buruli Ulcer outreach programs being piloted in the district, 4) school-based screening programs conducted as stand-alone and follow-up activities to mass outreach events, and 5) house to house active surveillance activities conducted in thirty-eight communities.', 'The study reaffirms that cholera continues to occur throughout a large part of India and identifies the burden hotspots and risk factors.', 'Cholera continues to be a serious public health concern in developing countries and the global increase in the number of reported outbreaks suggests that activities to control the diseases and surveillance programs to identify or predict the occurrence of the next outbreaks are not adequate .']


Cluster  496
['Traditional Chinese medicine (TCM) is becoming increasingly popular and related adverse events are often ignored or underestimated', 'Cancer has also become a serious public health problem in China and caused more and more attention of the government and people in recent years .', 'Areca quid chewing is a serious problem in eastern Taiwan .', 'Evidence from various countries implies that toxic heavy metals and undeclared prescription drugs in Asian herbal medicines might constitute a serious health problem .', 'With the increasing incidence of cancer , poor access to affordable anticancer medicines has been a serious public health problem in China .', 'Violence against doctors in China is a serious problem that has attracted attention from both domestic and international media .', 'DR has become a serious public health problem in China .', 'Liver toxicity is a severe problem associated with Traditional Chinese Medicine ( TCM ) .', 'Previous reports of foreign-body ingestion focused primarily on accidental ingestion and very few studies focused on intentional ingestion of foreign body (FB) in China']


Cluster  2186
['This was a prospective randomised interventional study conducted in a tertiary care teaching hospital of a developing country.', 'For Tibetan patients, a significantly higher incidence (P < 0.', 'A prospective, observational clinical study was carried out in the outpatient setting of nodal ART center of Eastern India.', 'A prospective, randomized, double-blind, single-center placebo-controlled study was performed at Sudbhawana Hospital, Varanasi, India between May 2016 and September 2016.', 'This was a retrospective observational study performed in Chiang Mai University Hospital.', 'A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India.', 'This is a single-center retrospective observational study in a Malaysian tertiary referral center.']


Cluster  1899
['Infection was significantly more common in the group that did not receive prophylaxis.', 'Infections pose a serious global public health problem and are a major cause of premature mortality worldwide .', 'Healthcare-associated infections are a serious worldwide health concern .', 'Infectious diseases caused by pathogens have become a life-threatening problem for millions of people around the world in recent years .', 'Infectious and endemic diseases are a serious public health concern worldwide , and their prevention and treatment are globally controversial .', 'Infections are a serious health concern worldwide , particularly in vulnerable populations such as the immunocompromised , elderly , and young .', 'Following implementation, infection rates decreased (P = .', 'Infectious diseases are a serious global problem , which not only take an enormous human toll but also incur tremendous economic losses .', 'Infectious diseases remain a serious public health concern globally , while the need for reliable and representative surveillance systems remains as acute as ever .', 'Emerging infections are a serious concern for both the public and healthcare practitioners .', 'Healthcare-associated infections are a serious public health concern resulting in morbidity and mortality particularly in developing countries .', 'Observational study using a consecutive sample of patients admitted to the unit for infectious diseases at a University Hospital in Sweden, February to April 2014.', 'Our results provide useful epidemiological information for the control of these infections , which remain a serious public health problem all over the world .']


Cluster  1058
['Diabetes in pregnant Mexican-American women is a serious and expensive health problem .', 'For obese indigenous people with diabetes , a regionalized model of care centred on the LAGB is an effective approach to a serious health problem .', 'Diabetes in Mexico -- a serious and growing problem .', 'The increase in the prevalence of diabetes has become a severe problem around the world ; mainly affecting indigenous communities as the Mayan of Yucatán in Mexico .', 'Gestational Diabetes Mellitus ( GDM ) is a serious health concern for pregnant women , with Hispanic women at particular risk for developing the condition .', 'Non-insulin-dependent diabetes mellitus ( NIDDM ) is a serious health problem among the Zuni Indians of New Mexico .', 'Diabetes has emerged as a serious health problem in the Navajo nation , the largest Indigenous tribe in the US .', 'In Mexico , diabetes represents a serious public health problem and a high-cost disease for the health system .']


Cluster  306
['Participant in the face-to-face condition reported significantly higher levels of motivation and showed higher levels of adherence compared to participants in the online condition.', 'Information given about the rationale for a study could influence symptom reduction in online treatments for patients with MDD.', 'Internet-based interventions are a viable treatment option for various mental problems.', 'Evidence for the efficacy of computer-based psychological interventions is growing.', 'This study aimed to compare online awareness and error behaviour of two participants with TBI with two matched controls during tasks of meaning and importance to the participants with TBI, using an occupation-based online awareness assessment.', 'This paper presents the results of a web-based randomized controlled trial of Manage Your Life Online (MYLO), a program that uses artificial intelligence to engage the participant in a conversation across any problem topic.', 'This study builds upon previous research, by utilising an individualised, occupation-based approach to assess error behaviour and online awareness.', 'Cognitive analytic guided self-help (CAT-SH) met established quality parameters for guided self-help.', 'The manual was an adaptation of existing manuals based on Motivational Enhancement and Cognitive Behaviour Therapy and was used in a feasibility randomized controlled trial, the EBI-LD study.', 'The study examined the efficacy of a web-based unguided self-help programme with automated feedback.']


Cluster  448
['To compare the clinical outcome after Discover arthroplasty versus anterior cervical discectomy and fusion (ACDF) in patients treated for symptomatic single-level cervical disk disease.', 'Cervical is a troublesome clinical problem .', 'Cervical lesions were confirmed in 57\u2009% of the patients.', 'A retrospective review of 52 patients with cervical chordoma operated in our institution from January 1999 to March 2015 was performed.', 'We prospectively collected data on subjects who underwent cervical SCS via numeric rating scale (NRS), McGill Pain Questionnaire, Oswestry Disability Index (ODI), and Beck Depression Inventory.', 'At 7 and 10 years, cervical arthroplasty compares favorably with ACDF as defined by standard outcomes scores in a highly selected population with radiculopathy.', 'The cervical-lesion and non-cervical-lesion groups included 106 and 79 patients, respectively.', 'To compare the long-term clinical and radiographic results of cervical artificial disk replacement (CADR) and anterior cervical discectomy and fusion (ACDF), and to provide our evidence if CADR could reduce adjacent segment degeneration (ASD).', 'Contiguous vertebral segments involved, intralesional surgical margin, without adjuvant radiotherapy, and incisional biopsy significantly increase local recurrence, while tumor location in the upper cervical spine significantly increases tumor-related mortality.', 'Due to absence of high level of evidence, the authors believe that a RCT will improve the evidence for using the different surgical treatments for cervical radiculopathy and strengthen current surgical treatment recommendation.']


Cluster  1288
["Vascular insufficiency of the child 's brain is a serious problem because perfusion can be disturbed sufficiently enough to cause permanent brain changes with extensive neurological deficit resulting in some .", 'Hydrocephalus is a serious problem in sub-Saharan Africa , whose effects can be minimized by a better organization of the health system in hydrocephalus prevention , referral , and follow-up .', 'The increase of intracranial pressure is a life-threatening condition which requires urgent treatment to prevent the further neurologic problem .', 'Making of precise diagnosis is a serious problem of modern pediatric neurology .', 'CNCLUSIONS : This preliminary study concludes that the rate of Pacific SIDS increased in 1995 and remains a serious problem .', 'Intracranial haemorrhage is a serious problem in haemostatic disorders in children .', 'This study aimed to evaluate the association between misdiagnosis of spontaneous intracranial hypotension (SIH) and subdural hematoma development.', 'The incidences of extracranial and intracranial suppurative complications of AOM in children have decreased significantly , yet they remain a serious clinical problem , especially when caused by bacteria resistant to antibiotics .', 'A multidisciplinary approach involving neurosurgeons, ophthalmologists, radiologists, and neurologists is integral in the management of patients with IIH to prevent the complications of papilledema.', 'Paediatric early warning score (PEWS) assessment tools can assist healthcare providers in the timely detection and recognition of subtle patient condition changes signalling clinical deterioration.']


Cluster  1349
['Vocal : elements that accompany verbal communication with two main features involved : Nature of voice -LRB- e.g. . unsupervised training erasing what was learned from the manually annotated corpus', 'Obtained lexical entries are guaranteed to construct well-formed HPSG parse trees because HPSG schemas and principles are successfully applied during the development of the HPSG treebank . prosodic cues are never absolute ; they are relative to individual speakers , gender , dialect , discourse context , local context , phonological environment , and many other factors', 'The high frequency information of consonant messages is important for recognition of speech.', 'One major time and cost limitation in developing LVCSR systems in Indian languages is the need for large training data', 'Vocal : elements that accompany verbal communication with two main features involved : Nature of voice -LRB- e.g. . unsupervised training erasing what was learned from the manually annotated corpus', 'onomic structure by minimizing overall distances . our decoding algorithm , although efficient , still prunes the search space aggressively , while not being able to take advantage of look-ahead features as discriminative models can', 'The top panes show the waveform and the fundamental frequency -LRB- F0 -RRB- track . we have only considered single words as context', 'However , the current task adds two levels of complexity . some information gets lost in the thresholding that converts posterior probabilities from the prosodic model and the auxiliary LM into binary features']


Cluster  202
['Elevated salivary SP concentrations stimulated by capsaicin greatly improve the safety and efficacy of swallowing, and shorten the swallow response in older patients with OD.', '57% of the participants reported difficulties with mastication.', 'In short, reported mastication difficulties are prevalent in people with McArdle disease, most frequently in younger people.', 'Every participant of the study exhibited dry mouth sensation.', 'Thumb-sucking ; a preventable problem .', 'For some patients drooling may represent a severe social problem .', 'Swallowing disorders are a serious health concern among older adults .', 'New chamomile- and linseed-based saliva substitute was effective in relieving xerostomia symptoms in older participants of this study.', 'In particular , xerostomia - or dry mouth - caused by salivary gland injury is a serious problem suffered by most patients and leads to problems with oral comfort , dental health , speech and swallowing .', 'Since oral route is still widely accepted route but having a common drawback of difficulty in swallowing of tablets and capsules .']


Cluster  1924
['These features are ideal for exploring the relationship between free energy input and mechanical work output , but there is a serious problem in that this motor is severely inhibited by ADP .', 'Plantarflexors peak torque and DF-PROM significantly increased in the MWM group.', 'Increased motor fatigability was only present in elbow flexors of PwMS, indicating that expression of motor fatigability is not generalized.']


Cluster  1089
['To measure the distances between pulp cavities and the occlusal as well as the labial surfaces of equine incisors and to test if these distances change with age.', 'The aim of this study is to establish an objective classification system and also to subdivide by detailed description of damaged cuticle layers.', 'It will help the hair restoration surgeons and dermatologists to identify the various pattern and also to help in deciding the appropriate size of the punch in FUE.', 'A drawback of the study was that the plywood plates increased the contact area and therefore reduced the mean and maximum pressures in the claws they were attached', 'A general limitation with the published morphological studies are that different methods have been used in the assessment of microangiopathy , and there is also a risk of subjectivity in the results .']


Cluster  282
['Survey data showed that 94 % believed that it was a serious problem ; 89 % felt that it violated the rights of girls and women and 81 % supported criminalization .', 'This is not only a severe public health crisis but also a serious human rights concern .', 'Therefore , we believe that it deserves to be recognised as a serious problem of our time that needs to be addressed .', 'Yet , it is a serious problem in the medical writing arena .', 'This was found to be a serious problem and represents one of the main ongoing challenges .', 'This issue will represent a serious problem in the near future .', 'It is a serious problem for the affected persons and an increasingly important socio-economic problem as well .', 'It has become a serious problem in recent years .', 'However , resistance in the field is now a serious problem worldwide .', 'While it is difficult to conclude that it is actually escalating , the numerous studies do provide numbers that lead one to believe that it is a serious problem .', 'This has become a serious problem due to its invalidating and irreversible sequelae .', 'is still a serious problem in medical domain .', 'Mass panic is a serious problem that must be immediately identified and managed .', 'Still , even in these circumstances it remains a serious problem .', 'It calls attention to a serious problem that when mishandled can lead to a fatal outcome .', 'has emerged as a serious problem in recent years .', 'Ten percent of adults surveyed in America consider it a serious problem .', 'is emerging as a serious problem worldwide .', 'This is a serious problem that has both political and economic consequences on both sides of the border .', 'is emerging as a serious problem worldwide .', 'This is a serious problem that may increase in coming years .']


Cluster  2203
['Out of 322 patients, 50 (15.', 'One hundred patients were enrolled, 50 in each group.', 'A total of 200 patients were included, 50 in each group.', 'A total of 50 patients were included.', 'Of the 55 patients that were recruited, 3 (5.', 'Each group included 60 patients.']


Cluster  1279
['The lack of designated beds was a serious problem in two jurisdictions of Kinki and the Hokkaido Regional Bureau of Health and Welfare , with a " designated bed sufficient ratio " of 0.08 and 0.00 , respectively .', 'The results showed that Shenzhen and Dongguan have a severe problem with bed bug infestations : the control of bed bugs is a constant concern , except during the winter .', 'Approximately half of participants agreed or strongly agreed that BED is a serious problem ( male : 52.0 % ; female : 63.2 % ) requiring professional treatment ( male : 48.2 % ; female : 54.5 % ) .', 'Bed bugs have reemerged recently as a serious and growing problem not only in North America but in many parts of the world .']


Cluster  2123
['The direct and indirect costs of low back pain approach $ 24 billion per year in the U.S. It is in view of its high prevalence among populations of developed countries , of its heavy psychosocial and financial implications , and of the burden imposed on health services , that low back pain represents a severe public health problem .', 'Topics covered include the initial assessment of patients presenting with acute low back problems , identification of red flags that may indicate the presence of a serious underlying medical condition , initial management , special studies and diagnostic considerations , and further management considerations .', 'Chronic low back pain ( CLBP ) and chronic neck pain ( CNP ) have become a serious medical and socioeconomic problem in recent decades .', 'Work-related low back pain is a serious socioeconomic problem .', 'Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain .', 'Back pain is a common condition which has been described as a serious public health problem .', 'Low back pain ( LBP ) is a serious health problem among medical students .', 'A prospective study was conducted (Lower limb soft tissue injury cohort, n=88), (Acute low back pain cohort, n=29) at the emergency departments of two urban hospitals.', 'Low back disorders pose a serious health problem among workers engaged in heavy manual lifting and carrying .', 'Twenty-two healthy male university students without low back pain history participated this study.', 'Six hundred adults with low back pain from three centers were prospectively analyzed for history, examination, diagnosis, and the ordering of tests and treatments.', 'Nonspecific Chronic Low Back Pain (CLBP) is a condition difficult to treat due to multiple etiopathogenesis and there is wide consensus on the multidisciplinary approach.', 'Nineteen females CLBP were recruited according to Paris Task Force on Back Pain criteria.', 'Low back pain represents a serious public health problem .', 'Back pain poses a serious clinical problem in some cases , because under the clinical symptoms of back pain might be other hidden diseases .', 'The findings of our study indicate that patient compliance with back pain treatment is a serious and complex problem .', 'An observational study was conducted in an outpatient setting, where patients diagnosed as having non-specific low back pain were included.', 'Discogenic low back pain is a serious medical and social problem , and accounts for 26%-42 % of the patients with chronic low back pain .', 'Brazilian physical therapists are not using the best available evidence in their clinical decision making for patients with low back pain.', '(i) to investigate whether Brazilian physical therapists make clinical decisions for patients with low back pain based upon clinical practice guidelines and (ii) to determine whether the physical therapists are able to recognize differential diagnoses of low back pain associated with red or yellow flags.', 'Most patients present to the ED with acute exacerbations of chronic low back pain.', 'low back pain is a serious public health problem in particular among motorcycle drivers in our country where riding a motorcycle is becoming more and more a work to bring assistance to the population facing growing unemployment .', 'In this randomized controlled trial over 16 weeks (8 weeks of intervention, 8 weeks of follow-up), data of individuals with chronic lower back pain will be analyzed.']


Cluster  1442
['Lamotrigine was associated with higher odds of treatment response compared with placebo in the melancholic subgroup but not in the nonmelancholic subgroup.', 'Adult outpatients (n = 150) in an acute bipolar II depressive episode completed 8 weeks of treatment with lamotrigine (titrated to 200 mg/d) or placebo.', 'Further research is warranted to test the hypothesis that bipolar depression with melancholic symptoms is more responsive to lamotrigine over placebo than nonmelancholic bipolar depression.', 'In this exploratory pilot study we reanalyzed data from a previous randomized, double-blind, placebo-controlled trial of lamotrigine for bipolar II depression in which lamotrigine was not superior to placebo to determine if splitting the sample into melancholic and nonmelancholic subgroups revealed a significant treatment effect.']


Cluster  1261
['Drug-induced poisoning of children represents a serious medical as well as a social problem linked both to the fields of prevention and therapy .', 'Participants viewed poisoning as a serious problem to which all children are susceptible .', 'Accidental poisonings remain a serious problem among young children .', 'Acute paediatric poisonings represent a relatively frequent problem in Finland , and remain a life-threatening problem .', 'Toxic epidemics have become a serious problem during the twentieth century , due mainly to the huge expansion over the last 50 years of the chemical industry , which has placed tens of thousands of new synthetic organic compounds in the human environment .', 'Poisoning by these agents , either as acute or chronic in these nations , is a serious health problem .', 'Deliberate self-poisoning ( DSP ) is a common cause of intensive care hospitalization among young adults and a serious health problem worldwide .', 'Poisoning by means of hazardous chemicals through ignorance , mishap or intentionally is becoming a serious health problem worldwide .', 'Poisoning as a serious problem .', 'Rapid increases in self-poisoning particularly among young adults present a serious public health problem .', 'Pharmaceutical drug poisonings , especially those that are intentional , are a serious problem for adolescents and young adults .', 'Acute poisoning is a serious health problem that is associated with high mortality .']


Cluster  2281
['Human brucellosis represents a serious public health concern in Hulun Buir and requires a comprehensive epidemiologic analysis to define adapted control measures .', 'Brucellosis remains a serious public health problem in Turkey .', 'The Brucella melitensis chronic infection and drug resistance emerged as a severe health problem in humans and domestic cattle .', 'In epidemic regions of the world , brucellosis is a reemerging zoonosis with minimal mortality but is a serious public hygiene problem .', 'Our findings confirm that Brucella spp . circulates among dairy cattle supplying milk to urban consumers in West and Central Africa , posing a serious public health concern .', 'Human brucellosis is a serious problem in the Republic of Macedonia presenting with a high percentage of localized forms , relapses and therapeutic failures .', 'A sharp rise in both animal and human brucellosis incidence has become a serious problem .', 'Brucellosis is a serious public health problem primarily affecting livestock workers .', 'Brucellar arthritis remains a serious a problem in Mediterranean countries .', 'Brucellosis is a serious problem in Sicily .', 'Human brucellosis , as a zoonosis , is a serious public health problem in many developing countries , including China .', 'Brucella spp . is a common zoonotic infection referred to as Brucellosis , and it is a serious public health problem around the world .', 'In developing countries , brucellosis remains a serious problem , and the importance of its control has attracted little attention .', 'The gram-negative bacteria of the genus Brucella are facultative intracellular parasites that cause brucellosis , a world wide-distributed zoonotic disease that represents a serious problem for animal and human health .']


Cluster  224
['Patients undergoing LC in a single centre were randomized into ICGFC-LC and conventional LC.', 'EBD for strictures secondary to CD provides not only short-term success but also long-term efficacy.', 'Prospectively collected data from 107 consecutive surgical patients with CSDH were reviewed.', 'A total of 1093 patients underwent elective LC, and 232 (21.', 'In this prospective-randomized study, 76 patients undergoing surgery for CSDH were divided into 2 groups using computer-generated randomized tables; Dex group ([n=38]; received IV bolus of dexmedetomidine 1 mcg/kg over 10 min followed by maintenance infusion 0.', '422 patients received Clensia (n=213) or PEG 4L (n=209).', 'Between 2011 and 2015, 29 patients with LCIS who underwent initial excision were enrolled.', 'Twenty-six patients with CD who underwent EBD for strictures from August 2008 to November 2015 were followed up after dilatation.', 'If utilizing a protocol where an EIS score ≤ 3 requires no SDDI and ≥ 7 requires immediate excision, it reduced the need for SDDI by 46·9% (n = 75/160; 95% CI 39·0-54·9).']


Cluster  904
['We evaluated the immunohistochemical expression of the estrogen receptor (ER), progesterone receptor (PR), and androgen receptor (AR) in six cases of PCMC.', 'The aim of this research was to analyze digit ratio in relation to estrogen receptor (ER) and progesterone receptor (PR) expression and to verify digit ratio (2D: 4D) as a marker of ER and PR overexpression in the male breast.', 'The mean urinary androsterone/etiocholanolone (An/Et) ratio in sex-steroid pathways significantly decreased from 1.', 'With a greater understanding of estrogen action , the major problem with the current estrogens in MHT appears to be that they are nonselective .', 'The problem with DHEA , however , the exclusive source of androgens in women of all ages , is that DHEA secretion has already decreased by an average of 60 % at time of menopause and continues to decrease thereafter .', 'To examine estrogen receptor-beta ( ERbeta ) expression in prostate cancer ( CaP ) metastases , thereby providing a basis for conducting estrogen therapy studies in patients with metastatic CaP. Advanced androgen-independent CaP is a serious health problem with no effective treatment at present .', 'The problem with DHEA , however , is that its secretion decreases from the age of 30 years and is already decreased , on average , by 60 % at time of menopause .']


Cluster  280
['All procedures led to cure of C. difficile colitis.', "A total of 46 patients with ulcerative colitis or Crohn's disease were randomized.", 'This multicentre, observational, prospective study was conducted using a cohort of consecutive patients with ulcerative colitis.', 'The treatment of a severe relapse of colitis in a patient who has had one episode of steroid related BIH remains a dilemma .', "This was an observational, single-center, longitudinal, retrospective study with Crohn's disease patients under infliximab or adalimumab therapy.", 'Prospectively, consecutive 333 ulcerative colitis patients operated adopting different IPAA techniques during the open surgery period 1984-2011 were enrolled.', "We performed a retrospective and observational study including all Crohn's disease patients who underwent dose escalation of adalimumab after a secondary loss of response from 2007 to 2015.", 'This was a retrospective observational review of the clinical charts of 34 patients with moderate to severe ulcerative colitis refractory to steroids treated with oral tacrolimus at our hospital (July 2001-July 2016).', "Prospective, observational, anonymous study conducted in 117 outpatients with Crohn's disease or ulcerative colitis.", 'In prospective observational study, FMT was performed using fresh specimen from healthy unrelated donors to the patients with recurrent or refractory C. difficile colitis.']


Cluster  985
['High-volume hospitals are significantly associated with surgery use and improved surgical outcomes.', 'This prospective, observational study was carried out in the surgical Intensive Care Unit of the First Affiliated Hospital of Sun Yat-sen University from December 2013 to July 2015.', 'The is an exploratory, observational, descriptive research conducted in the surgical center of a university hospital between August 2017 and July 2018.', "A surgery on COVID-19 patients not only involves a risk of spread of the disease but also there is a serious concern for the patient 's surgical outcomes and resources requirement .", 'A prospective study of 28 adult critical surgical patients was performed.', 'During the past 15\u2009years there has been a weekend effect in patients undergoing\u2009emergency general surgery based on day of operation, but not day of admission.', 'The aim of the study was to gain insight in the involvement of non-operating surgeons in intraoperative surgical decision making at a teaching hospital.', 'A higher incidence of incorrect surgical counts was observed among surgical counts performed between 8:00\u2009a.m. to 12:00\u2009a.m., emergency operations, prolonged procedures, and/or after addition of surgical items.', 'Observational audit of 10 surgical teams and 33 semi-structured interviews with 70 participants from nursing, medicine and the community were conducted.', 'We performed a retrospective observational study using data from the National Surgical Quality Improvement Program database from 2007 to 2013.', 'Patient optimization preceding elective surgery is critical to ensure the best possible outcome', 'This prospective observational study from a consortium of 16 hospitals evaluated crude in-hospital mortality over 5 years and productivity of operations performed during and after completion of a 3-year surgical training programme.', 'The decision to operate is usually informed by the urgent or emergent need to correct a severe surgical problem and weighed against the higher risks of morbidity and mortality from the procedure itself .']


Cluster  1029
['These partially lexicalized rules fit the pattern -LRB- 5 = w X1 , T = X1 w -RRB- and handle cases of lexicalized binary reordering between French and English . combinatorial explosion', 'It is interesting that the phrase-based model is able to capture the fact that reordering increases with the RQuantity of the test set . evaluation data is hard to get', 'Combinatory Categorial Grammar -LRB- Steedman , 2000 -RRB- is a grammatical framework that describes syntactic structure in terms of the combinatory potential of the lexical -LRB- word-level -RRB- items . this is expensive', 'Another limitation is that these models are restricted to reorderings with no gaps and phrases that are adjacent', 'This particular ordering of theories is based on the ordering of meanings of the corresponding words in dictionaries -LRB- derived and less frequent meanings have lower priority -RRB- . the word form of an unknown word often contains useful information that is not available in the present setup', 'Combinatory Categorial Grammar -LRB- Steedman , 2000 -RRB- is a grammatical framework that describes syntactic structure in terms of the combinatory potential of the lexical -LRB- word-level -RRB- items . this is expensive']


Cluster  1350
['TR after mitral valve replacement in rheumatic heart disease is a serious clinical problem .', 'However , heterogeneity between classification systems of mitral valve disease severity is a serious problem .', 'Twenty-nine patients (63\u2009±\u200910 years) with severe primary mitral regurgitation underwent surgical MVR using ring annuloplasty with or without neochord implantation.', 'Rheumatic mitral regurgitation in the young remains a serious problem .', 'Several studies have described the association between metabolic syndrome and ischaemic heart disease , however , none linked metabolic syndrome to ischemic mitral regurgitation , a serious clinical problem facing both the cardiologists and cardiac surgeons .']


Cluster  939
['Using notification data and clinical records review, we conducted a retrospective observational study of patients diagnosed with BU in Victoria from 1998-2015.', 'A survey was carried out using the clinical examination and a questionnaire on 3212 first-time outpatients in our dermatology department, and 102 cases of ABNOM were subsequently enrolled.', 'Stigma is a serious concern for individuals with BD and their families .', 'A greater proportion of BCA patients had a primary diagnosis of phobic disorder.', 'The outpatient prevalence of ABNOM was 3.']


Cluster  1962
['As one of the top malignancies in the world , GC has already become a serious concern to public health with poor prognosis .', 'Despite the incidence of GC has decreased over the past few decades , it is still a serious health problem .', 'Despite being a benign condition , GGM can turn into a serious problem .', 'However , a serious problem associated with GM3 is that it is poorly immunogenic .', "GMC is a troublesome health problem in some developing countries , and it can result in the limitation of patients ' hip function , leading to the development of inferiority complexes ."]


Cluster  1031
['An abnormal lowest ABI (calculated with the lowest ankle systolic pressure) is the most important independent predictor of an abnormal ABI response to exercise in patients with a conventionally normal ABI.', 'We hypothesized that the lowest ankle systolic pressure to calculate the resting ABI would be associated with an abnormal post-exercise ABI.', 'The TBI data were recorded from 97 people with subnormal toe pressures.', 'Using multivariate analysis, the lowest ABI (calculated using the lowest and not the highest ankle systolic pressure) was consistently the most powerful independent predictor of an abnormal postexercise ABI.', 'Accurate and consistent TBI readings cannot be assumed for people with subnormal toe pressures, and taking only a single reading or indiscriminately averaging readings seems inadvisable.']


Cluster  1096
['Hip fractures in the elderly are a serious problem for the health service due to the high rate of complications .', 'Hip fracture , the most dramatic complication of osteoporosis , constitutes a serious health problem of the elderly , with great socioeconomic consequences .', "The number of hip fracture surgeries exhibit an increasing trend due to the aging of the world 's population and it is expected to become a serious public health problem in the future .", 'Hip fractures in Italy are a serious medical problem and a leading health-cost driver .', 'Hip fracture is a serious health problem among older adults and often results in serious consequences such as disabilities .', 'Hip fracture is a serious public health problem .', 'Hip fractures constitute a serious and common health problem from both individual and public health perspectives .', 'Hip fractures have become a severe public health problem , especially in very elderly patients .', 'Hip fracture is a devastating health-care problem in a geriatric patient , leading to high mortality and morbidity .', 'Hip fracture in the elderly is a serious problem , and solutions to prevent falls are needed .', 'Hip fracture in the elderly is considered to be a serious sanitary problem .', 'Both hip fractures and cardiovascular diseases represent in Italy a serious medical problem and a leading health cost driver , according to what has already been reported for many other Countries in the industrialized world , thus requiring a global clinical approach .']


Cluster  238
['In the cardiomyoblast cells, the autophagosomes were observed by immunostaining.', 'This study contributes to the role of "rare variants" in complex disease phenotypes and heterogeneity within family and the necessity of whole exome targeted approaches in complex cardiomyopathy, which are known to harbor private mutations.', 'VariousANK2mutations are associated with a wide range of phenotypes, including aLQTS, especially with ventricular fibrillation, representing "ankyrin-B" syndrome.', 'The purpose of this study is to help elucidate which part of the mitochondria is causing a problem through anamnesis, physical examination, and routine biochemical tests in the event of a suspected mitochondrial disease case.', 'In the cardiomyoblast cells, berberine reduced the autophagy and apoptosis induced by NaH<sub>2</sub>PO<sub>4</sub>.', 'There was substantial overlap of cell membrane n-3 PUFA content across PO and FO groups, and no group treatment effects on AF incidence or myocardial molecular marker levels were detected.', 'In spite of progress in diagnosis and treatment , hypertrophic obstructive cardiomyopathy ( HOCM ) remains a serious medical problem .', 'The accidental amplification of nuclear mitochondrial pseudogenes ( NUMTs ) can pose a serious problem for mitochondrial disease studies .']


Cluster  2051
['A single-institution retrospective chart review was performed for patients undergoing NSM from 1989 to 2017.', 'Thirty-four patients altogether, (21 females, mean age 82\xa0years) participated, 11 received FMT and 23 controls.', 'This is a monocenter randomized controlled non-inferiority trial that includes patients younger than 65\u2009years of age with ongoing symptoms of CMC1 OA and an established indication for surgery.', 'The MitraClip<sup>®</sup>procedure resulted in clinically meaningful improvements in MR severity, function and quality of life measures, and low MAE rates.', 'FMT could be considered as a promising rescue treatment modality before surgery in patients with refractory UC.', 'Hospitalized patients with CM-MO under withdrawal were enrolled.', 'A total of 54 ICM patients (87% male; mean age, 65\u2009±\u20097.', 'Three hundred and sixty patients were randomized (1:1) to using a single MAC3.']


Cluster  362
['In spite of the development of new antifungal drugs , epidemiological studies have shown that resistance to antifungal drugs among Candida isolates is becoming a serious problem .', 'In addition , intrinsic or acquired antifungal resistance may pose a serious problem to antifungal therapy .', 'In the recent years , there has been a marked increase in the incidence of treatment failures in candidiasis patients receiving long-term antifungal therapy , which has posed a serious problem in its successful use in chemotherapy .', 'Multidrug resistance may pose a serious problem to antifungal therapy .', "Poor bioavailability of antifungal drugs due to the various protective mechanisms of the eye is a serious concern for the treatment of corneal fungal infections in today 's world .", 'The occurrence of fungal diseases is a serious problem of the present medicine because of the development of drug resistance against the antifungal activities in the pathogen .', 'The increasing resistance to antifungal drugs especially of these new emerging pathogens is a severe problem for managing these IFIs .', 'In addition , this analysis suggests that antineoplastic agents and derivatives might find novel indications in the treatment of fungal infections , for which few agents are presently available , toxicity remains a serious concern , and drug resistance is emerging .', 'Miconazole nitrate is an antifungal drug with a drawback of poor skin-penetration in the treatment of deep seated fungal skin infections .', 'In addition to microbiological resistance to existing antifungal drugs , the large number of unexplained treatment failures is a serious concern .', 'The increasing clinical and microbiologic resistance of Candida spp . isolates to several antifungal agents is becoming a serious problem .', 'Although numerous antifungal agents are available , IFI remains a serious problem because of obstacles to timely diagnosis and high morbidity and mortality rates associated with such infection .', 'Single-dose fluconazole 150 mg is an effective treatment of oral thrush for individuals with advanced cancer.', 'Three antifungal agents (amphotericin B (AMB), ketoconazole (KET), and itraconazole (ITZ)) and three antibacterial drugs (ciprofloxacin (CIP), doxycycline (DOX), and metronidazole (MET)) with serial concentrations have been used and microdilution broth method has been done for single and combination therapy, then fungal growth was assessed spectrophotometrically, and the combinations were evaluated by bliss independent analysis.', 'The widespread emergence of antifungal drug resistance poses a severe clinical problem .', 'Fungal diseases are currently a serious public health problem , due to the limited number of fact-based effective principles , and the emergence of resistant strains to the polyenic antifungals .']


Cluster  366
['Staphylococcus aureus ( Sa ) is a serious concern due to increasing resistance to antibiotics .', 'Methicillin resistance in Staphylococcus aureus and in coagulase-negative staphylococci represents a serious problem both for the microbiologist and the physician .', 'Device associated infections caused by Staphylococcus aureus in hospitalised patients is a serious healthcare problem .', 'Antibiotic resistance is a serious problem in Staphylococcus epidermidis infections as many clinical isolates of this organism are resistant to up to eight different antibiotics .', 'Biofilm formation in association with the intercellular adhesion ( icaADBC ) gene cluster is a serious problem in nosocomial infections of Staphylococcus aureus .', 'Staphylococcus aureus is the most common cause of skin and soft tissue infections , and rapidly emerging antibiotic-resistant strains are creating a serious public health concern .', 'The investigation of methicillin resistance in Staphylococcus aureus ( MRSA ) is a serious problem for the physician and microbiologist .', 'The transmission of antibiotic resistant S. aureus ( ARSA ) , especially methicillin-resistant S. aureus , between food products and humans has become a serious problem .', 'Recent studies indicated increase in the resistance of S. aureus to different antibiotics , which is a serious problem in the treatment of infections resulting from S. aureus in this region .', 'Staphylococcus aureus biofilms formed on medical implants represent a serious problem , being difficult to eradicate with antibiotic therapy and leading to chronic infections .', '\ufeffStaphylococcus aureus continues to be a serious health problem worldwide due to its intrinsic nature of virulence , ability to cause a wide array of infection , and its capacity to develop resistance to a number of antibiotics .', 'Staphylococcus aureus is a serious current health care concern .', 'Multiple antibiotics resistance is becoming a serious problem in the management of Staph . aureus infections .', 'Drug-resistant staphylococci constitute a serious problem that urgently requires the discovery of new therapeutic agents .', 'The predominance of constitutive erythromycin resistance is a serious problem and limits the use of clindamycin for severe staphylococcal infections not only in this university hospital , but in many countries worldwide .', 'Ampicillin-resistant S. aureus ( ARSA ) now poses a serious problem for hospitalized patients , and their care providers .', 'Staphylococcus aureus has become a serious concern in hospitals and community due to rapid adaptation to existing antimicrobial agents .', 'It is concluded that the emergence of methicillin and gentamicin-tobramycin resistance among hospital staphylococci represents a serious , persistent problem .']


Cluster  668
['A single-center, randomized, open-label, parallel-group trial investigated pharmacokinetic interactions of oral semaglutide with omeprazole (40\xa0mg once-daily) in 54 healthy subjects.', 'Pharmacokinetic characteristics of selexipag and its metabolite ACT-333679 following administration of one adult tablet of 200\xa0µg selexipag and four paediatric tablets of 50\xa0µg selexipag were comparable.', 'The addition of selexipag to background double combination therapy with an ERA and PDE-5i provides an incremental benefit similar to that seen in the overall population, including in patients with WHO FC II or III symptoms at baseline.', 'In this post hoc analysis, hazard ratios (HRs) and 95% confidence intervals (CI) were calculated using Cox proportional-hazard models to determine response to selexipag versus placebo on the composite primary endpoint of morbidity/mortality.', 'Selegiline monotherapy reduced the primary outcome measure by -6.', 'Exposure of semaglutide appeared to be slightly increased, although not statistically significantly, with oral semaglutide plus omeprazole versus oral semaglutide alone (AUC<sub>0-24h,semaglutide,Day10</sub> [estimated treatment ratio 1.']


Cluster  1802
['Serum ferritin levels showed a statistically significant negative correlation with T2 hepatic MRI (r = -0.', 'Mean serum ferritin was 13·8 µg L<sup>-1</sup> in the LF arm compared to 231 µg L<sup>-1</sup> in the HF group (P < 0·001).', 'CCI showed the highest degree of correlation with ferritin (r\u2009=\u2009-0·373 for men and r\u2009=\u2009-0·590 for women) and the highest area under the curve (0·961 for men and 0·864 for women).', 'As serum ferritin non-response was associated with LIC decrease in over half of patients, use of liver MRI may be particularly useful for differentiating true from apparent non-responders to deferasirox based on serum ferritin trends alone.']


Cluster  1303
['Post-deep vein thrombosis ( DVT ) venous insufficiency is a vexing problem despite effective anticoagulation , and is characterized by vein wall fibrosis .', 'Deep vein thrombosis is a severe health problem .', 'Venous thromboembolism ( VTE ) and its manifestations , including deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ) , pose a life-threatening health problem for thousands of people each year .', 'Venous thromboembolism ( VTE ) and deep vein thrombophlebitis ( DVT ) is a serious problem with high mortality and morbidity rates .', 'Venous thromboembolism ( VTE ) , comprising deep vein thrombosis and pulmonary embolism , is a serious clinical and public health concern .', 'Venous thromboembolism ( VTE ) , which is characterized by pulmonary embolism and deep vein thrombosis , has become a serious public concern .', 'Venous thromboembolism is a serious health problem and a significant cause of morbidity and mortality .', 'Venous thromboembolism ( VTE ) is a serious medical problem and is one of the most important preventable causes of mortality and morbidity in hospitalized patients .', 'Venous thromboembolism ( VTE ) , which includes deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ) , is a serious health and social care problem of the developed world , affecting 1 in 1000 adults every year , and with an annual financial overhead of approximately £ 640 million .', 'Venous thromboembolism ( VTE ) is a serious health problem for which pharmacological prophylaxis has been proven to be effective .', 'Venous thromboembolism ( VTE ) remains a serious problem , and treatments surrounding this potentially life-threatening disease continue to evolve .', 'Deep Vein Thrombosis ( DVT ) is a life threatening condition and a serious concern among hospitalised patients , with death occurring in approximately 6 % of cases .', 'Venous thromboembolism ( VTE ) prophylaxis , despite evidence for its efficacy , is not reliably and consistently prescribed , and is currently a serious concern for patient safety .']


Cluster  885
['Evaluate the efficacy and safety of continuous low-intensity warfarin therapy throughout the periprocedural period of RFCA for AF in the elderly.', 'Superwarfarin toxicity may be a serious problem .', 'Patients who discontinued warfarin for 5 days and had an INR of 1.', 'In ECLIPSE II (NCT01431690), 26 participants received warfarin 25 mg on days 1 and 22 and OM3-CA 4 g once daily from day 8 to day 28.', 'While warfarin is the most commonly prescribed medication to prevent thromboembolic disorders , the risk of adverse drug reactions ( ADR ) poses a serious concern .', 'Interactions of warfarin with other drugs or substances can pose a serious problem .', 'In ECLIPSE II, 90% CIs for LSM ratios of with:without OM3-CA fell within 80-125% for AUC and C <sub>max</sub> of S- and R-warfarin enantiomers.', 'Uninterrupted low-intensity warfarin for RFCA of AF might be as effective as standard-intensity warfarin in preventing periprocedural thromboembolic complications and might be associated with fewer bleeding events in the elderly.']


Cluster  532
['On the other hand , the uniform description of all the electronic states of a given system is a known drawback of these functionals that causes varying accuracy in the description of states with different degrees of localization .', 'However , the Shift-FR is prone to a serious problem , in that it causes strong aliasing errors in short distance propagation .', 'Thus , spectral shift might not pose a severe problem for tone recognition , and allocation of wider frequency range to include more low frequency information might be beneficial for tone recognition .', 'This function has the disadvantage that longer definitions are prefered over short ones', "However , a common drawback of such methods is that the decomposition primitives are usually presumed from the onset , which may bias our understanding of the signal 's structure .", 'Intervals have a very obvious weakness in that the highly precise choice of endpoints can rarely be wellmotivated in natural domains such as these', 'However a major drawback of the F&K spectral analysis is that it changes when the PSI algorithm is rotated or its reference signal is time-shifted .']


Cluster  2239
['We will evaluate the eligible patients diagnosed with the mid-shaft clavicle fractures in our hospital from December 2020 to December 2021.', 'It was hypothesized that in the case of clavicular comminuted mid-shaft fracture, for the open reduction and internal fixation, its nonunion rate was lower and satisfaction rate was higher, although there were a variety of complications.', 'We undertook a multicenter randomized controlled trial to compare effectiveness and safety between nonoperative management and ORIF (open reduction and internal fixation) for displaced midshaft clavicle fractures in adults.', 'A retrospective study using radiographs collected as part of a previous study on clavicular fractures.']


Cluster  497
['In this prospective and observational study, enzyme-linked immunosorbent assay was used to detect serum netrin-1 concentrations in 50 mild TBI patients (Glasgow coma scale (GCS) score, 13-15), 83 moderate TBI patients (GCS score, 9-12), 69 severe TBI patients (GCS score, 3-8) and 50 healthy controls.', 'Serum netrin-1 might serve as a potential biomarker for prognosis of TBI.', 'Despite this increased focus on identifying biomarkers for outcome prognostication after a severe TBI , several challenges still exist in effectively modeling the significant heterogeneity observed in TBI-related pathology , as well as the biomarker-outcome relationships .', 'This study aimed to explore the efficacy and safety of recombinant human erythropoietin (RHE) for the treatment of severe traumatic brain injury (STBI).', 'Serum netrin-1 concentrations were significantly lower in moderate or severe TBI patients than in controls and in severe TBI patients than in moderate TBI patients, while not in mild TBI patients than in controls.', 'Inflammasome proteins are potential biomarkers to assess early brain injury and to predict functional outcome after SAH.', 'The increased survival after a severe acquired brain injury ( sABI ) raise the problem of making most effective the treatments in Intensive Care Unit (ICU)/Neurointensive Care Unit ( NICU ) , also integrating rehabilitation care .']


Cluster  423
['This study examined racial and ethnic differences in professional service use by older African Americans , Black Caribbeans , and Non-Hispanic Whites in response to a serious personal problem .', 'This study shares the challenges and successes for depression screening and implementing Internet-based mental health interventions for urban racial/ethnic minority adolescents in primary care settings.', 'The underuse of mental health services among black Americans remains a serious concern .', 'Use of ministers for a serious personal problem among African Americans : findings from the national survey of American life .', 'Professional Service Use for a Serious Personal Problem : Comparing Older African Americans , Black Caribbeans , and Non-Hispanic Whites Using the National Survey of American Life .', 'The implications of failure to recognize the possibility of depression among elderly White men suggest a serious public health problem .', 'Although there was some indication that blacks may be more tolerant of depressive symptoms , a considerable proportion of blacks who felt they had a troublesome problem had never sought professional care .']


Cluster  647
['Furthermore , the advances made in clinical medicine mean that induced immunosuppression , for instance as a result of major surgery or organ transplantation , has become a serious problem in intensive care units .', 'In patients with disturbed immunoreactivity caused by trauma or immunosuppressive therapy infections are still a severe problem .', '169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs.', 'PAD exacerbations in the context of ICI treatment are common, although generally mild, and occur despite background immunosuppression.', 'Adjuvant immunotherapy after nephrectomy may be beneficial in pT2b-3cN0 RCC.', 'In contrast to Western countries, early immunosuppression (even steroid monotherapy) in our patients is associated with better remission in the 1<sup>st</sup> year and renal preserve.', 'Primary end point of the present study was to analyze renal function in HTX patients 1 year after switch to an mTOR/CNI-based immunosuppression.', 'The present study detected no significant differences between both mTOR/CNI study groups, indicating a steady state of renal function in HTX patients after switch of immunosuppressive regimen.']


Cluster  2022
['This publication has emanated from research conducted with the financial support of Science Foundation Ireland under Grant Number SFI/12/RC / 2289 . the selection of only a single alignment from the distribution of source words at the end of 1,000 walks , since this does not allow for one-to-many mappings', 'This publication has emanated from research conducted with the financial support of Science Foundation Ireland under Grant Number SFI/12/RC / 2289 . the selection of only a single alignment from the distribution of source words at the end of 1,000 walks , since this does not allow for one-to-many mappings', 'This publication has emanated from research conducted with the financial support of Science Foundation Ireland under Grant Number SFI/12/RC / 2289 . the selection of only a single alignment from the distribution of source words at the end of 1,000 walks , since this does not allow for one-to-many mappings']


Cluster  2248
['In India , TB and HIV co-infection remains as a serious public health problem .', 'Seventy-four (70%) of the investigated population were HIV-positive, and 46 (44%) patients were being treated for drug-resistant TB.', 'The pandemic spread of tuberculosis ( TB ) and human immunodeficiency virus ( HIV ) represents a serious world problem .', 'The situation of tuberculosis ( TB ) is being modified by the human immunodeficiency virus ( HIV ) , which is increasing the occurrence of new cases and the generation of drug resistant strains , affecting not only the people infected with HIV , but also their close contacts and the general population , conforming a serious public health concern .', 'Tuberculosis occurring with human immunodeficiency virus ( HIV ) infection is a serious and growing public health problem .', 'Co-infection of tuberculosis ( TB ) and HIV is a serious problem in most developing countries and in industrialized countries , co-infection of TB and HIV is seen mainly among migrant population .', 'TB-HIV co-infection in southern Papua , Indonesia , is a serious emerging problem especially among the Indigenous population , and has risen rapidly in the last 5 years .']


Cluster  305
['Twenty-one women with SD were treated monthly for 2 months with VSP Er:YAG laser resurfacing using a 7-mm spot size.', 'Post-operatively, the mean maximal alpha angle improved significantly in the navigated group compared with the conventional group (55°vs.', 'The results of this study will provide evidence to judge whether sigmoidectomy can benefit patients with SCC.', 'In Group I, results were as follows: 28% (n = 7) achieved >75% repigmentation, 16% (n = 4) achieved 50% to 75% repigmentation, 52% (n = 13) achieved 25% to 50% repigmentation, and 4% (n = 1) achieved <25% repigmentation.', 'In both SP&SM and SP only group, volume of SD measured by Visioscan VC98 reduced significantly at 6-month follow-up visit (P=.', 'In spite of comparable medium-term clinical and radiographic outcomes, when the residual ridge height is sufficient for a safe placement, SIs may be preferred due to simplified protocol, less invasiveness, shorter treatment time, and reduced postoperative discomfort as compared to SA.', 'The mean number of sessions was lower in the scleroligation group than in the band ligation group (2.', 'Navigated surgery is effective for patients with cam type FAI in helping restore normal anatomy, however, not without drawbacks.', 'Scleroligation appears to achieve a faster rate of eradication with fewer treatment sessions and total number of bands deployed to achieve variceal obliteration than band ligation and is comparable in cost and in adverse event and recurrence rates.', 'Augmented ridge underwent horizontal volume reduction during the healing period.', 'Of the 120 patients who completed assessments, 16/120 (13%) had SCC after surgery, and 41/120 (34%) had objective decline.', 'In this single-blinded, randomized study, 15 female subjects aged 45-70 years underwent laser resurfacing of the face.', 'This new drug regimen using CsA resulted in rapid and uniform repigmentation without leaving any perilesional halo in Group II patients after NCMKT.']


Cluster  518
['This was a retrospective institutional review board-approved observational study conducted on microscopic images of 79 MCCs and 74 other SRBC tumors (desmoplastic small round cell tumor, primitive neuroectodermal tumor, neuroblastoma, embryonal rhabdomyosarcoma, alveolar rhabdomyosarcoma, synovial sarcoma, carcinoid, metastatic small cell lung cancer, non-Hodgkin small cell lymphoma, retinoblastoma, medulloblastoma, nephroblastoma, small cell osteosarcoma, and round cell liposarcoma).', 'To assess if loupe magnification (LM) can enhance the visual assessment of BCC tumor margins resulting in a greater histological clearance.', 'Loupe magnification improved tumor margin assessment for facial BCC enabling a greater diameter of histological clearance.', 'Trabecular features were identified in over 72% of MCCs but only rarely in non-MCC SRBC tumors.']


Cluster  653
['However , chemotherapeutic regimens frequently cause side-effects , one of which is anemia , a severe clinical problem for cancer patients .', 'This was a prospective observational study that included chemotherapy-induced FN in hematologic or solid malignancy.', 'Thromboembolism is a severe and frequent problem in gynecologic malignancy .', 'Medication and short-term imaging are recommended for Chinese IMH patients with a hematoma thickness\u202f<\u202f10.', 'The problem of thrombosis in patients with metastatic diseases is a serious concern for clinicians .', 'This is a prospective, observational pilot study of 13 thrombocytopenic, haemato-oncologic patients, over 17 cycles of chemotherapy.', 'Reliable venous access is often a serious problem in the cancer chemotherapy patient .', 'HIPEC was performed with three protocols, different with regard to perfusion times and drugs: (mitomycinC/doxorubicin, 90min), (cisplatin, 90min) (oxaliplatin, 30min).', 'Thromboembolic events ( TEE ) are a serious clinical problem in multiple myeloma ( MM ) patients receiving thalidomide ( T ) .', 'Management of a hematoma is challenging when its size is substantial', 'Clinically , patients with advanced cancer are usually in a hypercoagulable state with elevated fibrinogen , and fibrin deposition around tumor mass is a serious problem in cancer chemotherapy .']


Cluster  1740
['Supplementation with vitamin D might prevent UTI, but confirmatory studies are needed.', 'A prospective observational cohort study was undertaken among patients admitted with a diagnosis of culture-proven UTI to the Internal Medicine Ward of the Hospital Naval Almirante Nef between February and November, 2011.', 'Urinary Tract Infection ( UTI ) causes a serious health problem and affects millions of people worldwide .', 'Bacterial resistance in UTI in Chinese females is a severe problem , which could be resulted from antimicrobial irrational use .', 'Women visiting primary health care with symptoms indicating uncomplicated UTI have symptoms for several days before seeking care and after consulting.', 'The association of mannose and NAC therapy resulted similar to the antibiotic therapy in preventing UTIs in patients submitted to urodynamic examination.', 'Initial empiric broad or narrow antibiotic coverage in HCA UTI patients who presented to the ED and required ICU admission had similar clinical outcomes.', 'Urinary tract infections ( UTI ) are a serious health problem affecting millions of people each year .', 'Evaluate the efficacy and safety of Angocin® in adult patients with catheter-associated UTIs.', 'Urinary tract infection ( UTI ) is a serious health problem affecting millions of people every year .', 'As the emergence of multiresistant strains is a serious problem , we assessed the feasibility of nonantibiotic treatment of UTI in patients with NLUTD .', 'Urinary tract infections ( UTIs ) are a serious healthcare dilemma influencing millions of patients every year and represent the second most frequent type of body infection .', 'This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences .']


Cluster  2359
['Micro/nanoplastics are ubiquitous in the environment and cause pollution of the aquatic ecosystem , in particular , which is a serious concern worldwide .', 'Microplastic ( 0.001 - 5 \xa0 mm ) is a serious problem for the environment and is globally distributed .', 'Increased pollution by plastics has become a serious global environmental problem , but the concerns for human health have been raised after reported presence of microplastics ( MPs ) and nanoplastics ( NPs ) in food and beverages .', 'These results indicate that microplastic accumulation on shorelines in the northern Gulf of Mexico may be a serious concern , and suggest that exposure to inputs from the Gulf is an important determinant of microplastic abundance .', 'The occurrence and accumulation of microplastics in wildlife and humans have become a serious global scale concern over the last decade .', 'As an emerging environmental pollutant , microplastics ( MPs ) are increasingly viewed as a serious health concern to terrestrial and aquatic ecosystems .', 'Comparisons with other studies from freshwater and marine beaches indicated similar relevance of plastic contamination , demonstrating for the first time that plastic pollution is a serious problem in the Paraná floodplain lakes .']


Cluster  790
['This study highlights the influence of CSS in the results of PSQ and catastrophising by chronic pain patients in comparison with healthy controls and acute pain patients.', 'Individuals with severe obesity displayed hypoalgesia to noxious electrical stimuli together with difficulty in grading experimental noxious thermal and electrical stimuli in between pain threshold and tolerance.', 'The aim of this study was to identify the differences in pain perception and pain processing in patients with without obesity.', 'These results suggest that the stool form is associated with pain perception and anxiety status.', 'The results of the present study suggest that verbally induced expectations of increased pain engage cortical physiological defensive systems that in turn mediate the experience of increased pain.', 'Subjects were presented a green or red cue followed by a train of either non painful or painful electrical stimuli, and expected hypoalgesia after the green and hyperalgesia after the red cue.', 'We compared three populations: healthy (HS, n=280), with acute pain (AP=110 patients), and chronic pain (CP=280 patients) by assessing their pain behaviour with the pain sensitivity questionnaire (PSQ-total and PSQ-minor).', 'The BSFS was significantly and positively associated with pain perception, and showed a significant association with anxiety states.', 'Placebo hypoalgesia and nocebo hyperalgesia differently affect sensory (pain perception) and motor components (pain avoidance) of pain.', 'The penalty scores differed significantly between patients with obesity and controls with higher penalty scores in patients with obesity for both nociceptive assays.', 'The average pain scores of Group LaserAnes, Group Anes, and Group Con are 3.']


Cluster  1513
['On the other hand , a major drawback of surgical delay is two sessions of surgery .', 'Parameters such as postoperative ventilation , inotropic support , ICU stay , and hospitalization can be kept at reasonable levels with acceptable long-term results , although rejection remains a serious problem .', 'However , a major drawback of this technology is that they use images acquired preoperatively , on which the surgical planning and intraoperative performance is based .', 'A significant drawback of this method is the single window of opportunity to administer treatments ( i.e. at the time of surgery ) .', 'Patient transfer from the operating room ( OR ) to the angiosuite has been a fundamental drawback of this type of approach .', 'Because there is no intravenous formula for statins , the interruption of statins in the postoperative period is a serious concern .', 'However , potential metabolic consequences in the early postoperative period as well as long term remain a serious problem .', 'However , initially stable patients undergoing delayed surgery may develop low cardiac output syndrome ( LCOS ) during the waiting period , which might be a major drawback of this strategy .', 'It is associated with low mortality rates , though postoperative diabetes remains a serious problem .', 'Retention of the critical steps is valuable because if performed incorrectly, these steps may cause harm to the patient.', 'Perioperative critical events represent a serious problem only in few cases of EVAR ; they are common but in many cases not predictable ; in most circumstances they can be easily corrected with adjunctive manoeuvres during the same procedure .', 'Despite a low failure rate in our series (literature failure rates vary between 12 and 85%), these results suggest that those actively offered a choice between surgery and PET are at greater risk of failure when choosing PET.']


Cluster  710
['Studies in the United States show that school students from some ethnic backgrounds are susceptible to stereotype threat, that this undermines their academic performance, and that a series of virtually zero-cost self-affirmation writing exercises can reduce these adverse effects', 'Fifteen male orienteers (30±8 years) participated in the study.', 'This randomized controlled trial evaluated whether training one of two social skills ("being able to say no" and "being able to demand") belonging to the domain "asserting one\'s rights" improves specifically the trained skill or the "asserting one\'s rights" domain in general.', 'From pre-training to 3-month follow-up, participants of the "demanding" condition improved significantly on the "being able to demand" scale of the "Short Version of the Insecurity Questionnaire" (p\xa0=\xa00.', 'The objective of this study is to explore the relationship between psychological capitals, coping style and anxiety response of Chinese college students, and provide ideas for the effective coping with the pressure situation', 'Given that anxiety is a severe psychological problem among Chinese military personnel , the present study examined whether high trait anxiety military personnel showed negative interpretation bias in real-world situations and whether their interpretations were influenced by self-relevance .', 'Individuals in the positive self-image group reported less social anxiety, discomfort and distress from social cost when compared with their pre-induction state.', 'Sixty-six university students (n\u2009=\u200939 female) completed a self-esteem measure and completed a cardiovascular stress-testing protocol involving repeated exposure to a mental arithmetic task.', 'Pythagorean Self-Awareness Intervention is a feasible and possibly effective stress management method for AV.']


Cluster  2267
['The proposed methodology addresses a major drawback of existing methodologies namely , their inability to use time series observation of state variables to quantify causality in complex systems .', 'The major problem with existing methods for quantifying the causality in the brain , e.g. Granger causality , is that they assume an multi-variate autoregressive signal model for the multi-channel EEG signals and do not take the nonlinear dependencies between neuronal oscillations into account .', 'However , based on conditional independence , conditional mutual information ( CMI ) is able to quantify nonlinearly direct relationships among variables from the observed data , superior to linear measures , but suffers from a serious problem of underestimation , in particular for those variables with tight associations in a network , which severely limits its applications .']


Cluster  618
['One-piece mandibuloplasty based on 3-dimensional printing model turned out to be very successful for the natural shaping of the lower jaw in the patients with the prominent mandible in terms of the technical efficiency and the aesthetic point of view.', 'Treatment of a skeletodental Class II vertical growth problem , combined with a severe arch length deficiency in both arches , presents a challenging orthodontic problem .', 'A patient had a serious esthetic problem : One maxillary central incisor was discolored and the other was malpositioned and fractured .', 'The bird-face deformity of a severe class II , high Frankfort-mandibular plane angle with significant retrogenia , often associated with diminutive condyles and reduced posterior face height , poses many challenges to the orthognathic surgeon .', 'This has provided the patient , who has a severe dentofacial problem , with the option of having all components of their malocclusion and facial aesthetic concerns addressed .', 'All of 14 patients who complaint prominent mandibular angle and chin were randomly allocated into 2 groups.', 'Recently, the mandibular body and chin shape are known to be important issue as well as the mandibular angle.', 'This has provided the patient , who has a severe dentofacial problem , with the option of having all components of their malocclusion and facial aesthetic concerns addressed .']


Cluster  2160
['Because stalking has only recently been recognized as a serious social problem and criminal justice concern , it is not surprising that there is little consensus among lawmakers about what constitutes stalking .', 'Stalking is a serious public health and societal concern affecting the college population .', 'Stalking is a widespread phenomenon and a serious problem for healthcare .', 'Much of what is presently known about stalking in a domestic context has been depicted by the popular press , typically following a tragic outcome , and suggests that it is a problem of increasing dimensions .']


Cluster  493
['The study participants consisted of 97 children.', 'Eighty-nine surveys were usable.', 'Seventy-one subjects were finally included in the survey.', 'Overall total scores were highest for the egregious security breach condition (81.', 'Eighty-two children (83% females) were included.', 'Of 132 participants, 87 completed surveys (65.', 'The survey was answered by 96.', 'A total of 96 students was recruited.', 'The pass rates were 98.', 'Ninety-five participants completed the program and were included in the statistical analysis.', 'Combined data analysis was conducted of the 92 (63.']


Cluster  1850
['Escalation of criminal violence among the youth population has become a major public policy issue and a serious public health problem .', 'Although youth violence is a serious concern in the United States , Asian American and Pacific Islander ( AAPI ) youth have generally been neglected as a demographic group for scholarly inquiry or community mobilization efforts .', 'Youth violence represents a serious problem affecting individuals , communities , and the larger society .', 'Interpersonal violence ( IPV ) in adolescence is a serious public health concern and may have lasting behavioral effects and implications for adult relationships .', 'Exposure to violence is a serious public health concern that compromises adolescents by affecting their behavior and psychological well-being .', 'School violent victimization is a serious public health problem among youth .', 'Previous research has demonstrated that exposure to violence ( ETV ) is a serious concern across the north-south socioeconomic divide .', 'Juvenile family violence is a serious social problem that requires more systematic research to identify the correlates of this behaviour and effective interventions to prevent or reduce its occurrence .', 'School violence is a serious social and public health problem prevalent worldwide .', 'Violence within the family is increasingly being recognized as a serious societal problem in the United States .', 'Familial violence poses a serious public health concern and has therefore received a considerable amount of attention from academics and practitioners alike .', 'Violence in childhood is a serious health , social and human rights concern globally , there is , however , little understanding about the factors that explain the various forms of violence in childhood .', 'Youth violence is a serious public health problem in Thailand , and yet is poorly understood and is thought to vary considerably between metropolitan and rural areas .', 'Violence directed against K-12 teachers is a serious problem that demands the immediate attention of researchers , providers of teacher pre-service and in-service training , school administrators , community leaders , and policymakers .']


Cluster  1633
['The results of this study demonstrated that methylphenidate could effectively improve mental fatigue and cognitive functions in patients with TBI.', 'The use of methylphenidate for cognitive enhancement is frequent among Brazilian undergraduate students and should be considered a serious public health problem , especially due to risks of harm and adverse effects associated with its use .', 'A methylphenidate (MPH) extended-release orally disintegrating tablet (MPH XR-ODT) formulation was recently approved for attention-deficit/hyperactivity disorder treatment in children 6 to 17 years of age.', 'Methylphenidate improved math productivity and accuracy in children with ADHD.', 'Sixty-three children with ADHD participated in a double-blind placebo-controlled crossover study comparing the effects of long-acting methylphenidate and placebo.']


Cluster  52
['\u2002Muscle cramps are common in the population, especially in athletes', 'Patients with musculoskeletal pain were mostly female, and had a lower education level and annual income.', 'These findings indicate that chronic pain is a serious secondary problem in individuals with SCI and underscore the need for further research aimed at delineating the causes of , and optimal treatments for , the various pain problems in this population .', 'The presence of pain in subjects undergoing confinement is persistent, with varying intensity and frequency based on age, gender, physical activity, and work status.', 'These results indicate that musculoskeletal pain is relatively common among the very old , but does not seem to be a severe problem for the majority , considering the low proportion of subjects using prescription analgesics regularly .', 'A total of 100 patients with liver cirrhosis and muscle cramps signed an informed consent to participate in this study.', 'Pain is a troublesome problem in multiple myeloma ( MM ) patients which may be affected by several pain syndromes sustained by different underlying causes and mechanisms- In this setting may be due to the disease itself , to its complications , to diagnostic procedures and therapeutic interventions .', 'However , there have been very few studies on the impact of Hsp90 inhibitors on pain or analgesia , a serious concern for cancer patients .', 'In surviving patients , chronic pain may be a serious problem , but the long term incidence and potential risk factors are not very well studied .', 'Chronic pain is a debilitating problem , and insights in the neurobiology of chronic pain are needed for the development of novel pain therapies .', 'Comparative study of Class I drugs in central poststroke pain (CPSP) is lacking.', 'Persistent non-cancer pain is a serious problem .', 'Pain can be a serious problem in patients with Guillain-Barré syndrome ( GBS ) .', 'Unrelieved pain is a serious clinical problem that has received little attention in bioethics .', 'Leg pains in CHD : a distressing symptom of a wider problem .', 'In patients diagnosed with coronary artery disease (CAD), we aimed to determine the characteristics and risk factors of co-occurring musculoskeletal pain and examine its effects on functional capacity, psychological status and health-related quality of life.', 'A total of 100 patients with (n= 50) and without (n= 50) musculoskeletal pain were enrolled.']


Cluster  911
['The purpose of this study was to examine the effect of a cardiac educational program on knowledge and self-care behaviors among patients with heart failure.', 'Social background is important in preventing admission/readmission of heart failure (HF) patients.', '[ Cardiology education at each level is still a serious problem ] .', 'Applying cardiac education program helps improve knowledge and self-care among patients with heart failure.', 'To examine whether individual and clinical characteristics, heart failure symptomatology, and the subcomponents of social support and social problem-solving increase the likelihood of depression in outpatients with heart failure.', 'A multidisciplinary supportive program for caregivers of heart failure patients had positive effects and provides a unique perspective of an intervention considering Chinese culture and customs.']


Cluster  968
['Bimatoprost drops were placed on the proximal nail folds of 45 subjects on one hand (medication group) and vehicle drops to the other hand (control group).', 'There is little data on HIV nail growth rate to compare our results, but what we see in the clinical practice is that this group of patients shows a faster nail growth rate, as has also been reported for longer eyelashes, and this could be an important factor in the cure rates of onychomycosis.', 'For the 38 subjects completing the study, the final mean nail growth of the hands, the net individual nail growth of the digits (excluding chipped nails), nail brittleness, and eye pressure readings were NS at P<.', 'Permanent paresthesia to sculptured nails . A distressing problem .', 'This study demonstrated that the daily ingestion of BCP increased nail growth and improved brittle nails in conjunction with a notable decrease in the frequency of broken nails.', 'The goal of this study was to investigate whether daily oral supplementation with collagen peptides alleviates the symptoms of brittle nails and improves nail growth rate.', 'The most common clinical nail change was distal onycholysis (93.', 'Despite the negative results in this pilot study on nail growth and brittleness, further studies with higher bimatoprost concentration (0.', 'An observational, prospective, cross-sectional study was performed in 500 patients with symptoms related to the nails and nail folds.']


Cluster  1906
['Diabetes mellitus ( DM ) is a serious public health problem and can cause long-term damage to the brain , resulting in cognitive impairment in these patients .', 'Metabolic syndrome ( MS ) is a serious public health problem , which can promote neuronal alterations in cognitive regions related to learning and memory processes , such as the hippocampus .', "Alzheimer 's disease ( AD ) and type 2 diabetes ( T2D ) are common diseases in the elderly , and the increasing number of patients with these diseases has become a serious health problem worldwide .", 'We thus propose that neurodegeneration is a possible cause of human obesity and related metabolic diseases , which have become a serious public health problem worldwide .', 'However , diabetes mellitus ( DM ) characterized by problems related to insulin secretion and recognition has become a serious health problem in recent years that threatens human health by causing decline in brain functions and finally leading to neurodegenerative diseases .', 'Together , aging and diabetes have contributed to dementia becoming a serious problem .']


Cluster  98
['The present study aimed to investigate the clinical efficacy of pumpkin seed oil (PSO) in the treatment of female pattern hair loss (FPHL) and compare its effects with minoxidil 5% foam.', 'Intradermal injections of this hair formulation may be a promising option for treating male as well as female patterns of hair loss.', 'To evaluate the efficacy and safety of combined fractional radiofrequency microneedling (FRM) and 5% topical minoxidil in the treatment of male pattern hair loss.', 'The objective of this study was to assess the efficacy and safety of the hair growth factor formulation in reducing hair loss and enhancing hair growth.', 'Every 1 SD increase in high-density lipoprotein (HDL) cholesterol was associated with a 0·65-times lower risk [95% confidence interval (CI) 0·46-0·91] of hair loss.', 'The 12-point scale classification system was demonstrated to be a more precise standardization and appropriate evaluation method to investigate the subtle distinction of the hair shaft after hair care product application.', 'A double-blind, randomized study was conducted in 10 patients undergoing hair transplant surgery by strip harvest after informed consent.', 'This clinical study provides evidence for safe and permanent axillary hair reduction, showing stable average reduction that lasted through the year of follow-up.', 'Unwanted hair can be reduced by both systems safely and effectively; however, IPL has less side effects and higher satisfaction scores.', 'Combined treatment with fractional radiofrequency microneedle and 5% topical minoxidil could be an effective and safe treatment option for male pattern hair loss.', 'The right and left axillae both showed significant hair reduction, between the first session and the hair count 6 months after the third laser session.', 'Six patients demonstrated partial hair regrowth in areas treated with 2% tofacitinib ointment applied twice daily.', 'Low HDL cholesterol and IGF-1 were associated with a higher risk of hair loss in women.', 'Among group A (pumpkin seed oil) candidates, a significant decrease was observed in hair shaft diversity before and after treatment (30.', 'Significant reduction in hair fall was seen in 83% of the patients on hair pull test.', 'Mean hair reduction in the IPL group was 25.', 'To compare the percentage of hair reduction in preshaved versus prewax epilated axillae after LHR in healthy adult Saudi females.', 'Our aim was to compare efficacy, satisfactory levels, safety, and side effects of Nd:YAG and IPL in hair reduction.', 'In this study, 129 premenopausal women affected by hirsutism were randomly divided into two study groups according to hair-shortening method: shaving as group A (66 patients) and hair shortening by scissor as group B (63 patients).']


Cluster  568
['The aim of this study is to assess the utility of targeted, framed, efficacy-enhancing messages on calcium consumption from dairy in adults aged 30-50 in a randomized controlled trial.', 'When healthier vending snacks are available, promotional signs are also important to ensure consumers purchase those items in greater amounts.', 'Prior work demonstrated significantly improved prescription label comprehension and functional health literacy (FHL) using an educational intervention and redesigned prescription label.', 'The objective of this study was to assess the effectiveness of the educational intervention to improve prescription label understanding using three factors: (1) redesigned prescription label, (2) previously validated MLT and (3) pillbox fill test.']


Cluster  2219
['Randomized controlled trial at the laparoscopic surgical training center, University of Tubingen with 45 surgical novices first year medical students being pretested for dexterity.', 'We conducted a randomized controlled trial of obstetrics-gynecology trainees, stratified on a simulator-assessed surgical skill.', 'There is evidence that preoperative practice prior to surgery can improve trainee performance, but the optimal approach has not been studied.', 'We designed a randomized controlled trial where residents (n\xa0=\xa034) were randomized to proficiency-based laparoscopic simulator training under either 3D or 2D conditions.', 'We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model.', "To evaluate the effectiveness of spaced learning, subjects were asked to perform four surgeon's square knots on a bowel model prior and post 3\xa0h of hands-on training.", 'The simple intraprocedural checklist significantly improved the laparoscopic task performance and the learning curve of laparoscopic novices.', '3D vision reduced time to proficiency on a virtual-reality laparoscopy simulator.', 'Current surgical education relies on simulated educational experiences or didactic sessions to teach low-frequency clinical events such as abdominal compartment syndrome (ACS).', 'Hands-on training is superior to video demonstration for teaching VE on a pelvic model.']


Cluster  1528
['The in vitro effect of nitroxoline on 100 isolates of yeasts from urine was tested by an agar diffusion test.', 'Obviously, this agent is still active against the vast majority of uropathogenic bacteria and in particular against strains of Escherichia coli (E.', 'However , this has not become a serious problem to date , as large scale evaluation has shown that the quinolones remain highly efficacious for the treatment of gonorrhoea .', 'The emergence of macrolide- or fluoroquinolone-resistant M.genitalium has become a serious problem in the treatment of male urethritis worldwide , but there is no commercial-based detecting kits accepted by the national insurance in Japan .', 'Allergic reactions form a serious problem in therapy with the urinary antiseptic nitrofurantoin ( NFT ) .', 'Contamination by the infected urine did not seem to be a serious problem when the rectal mucosa was swabbed proximal to the anal canal .', 'Nitroxoline is a\xa0reasonable alternative and a\xa0promising option for calculated treatment of urinary tract infections-especially of the elderly, although this drug is not recommended in the current guideline.']


Cluster  986
['Sixty female patients with chronic lateral ankle instability were randomly assigned and underwent surgical treatments by one surgeon.', 'The comparative results of 3 different total ankle systems (INBONE, STAR, and Salto Talaris) were evaluated.', 'Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA).', 'Balance and PNF programs are recommended in clinical practice for improving ankle ROM and functional performance in individuals with sprain.', 'This is the first study that compares the results of 3 different total ankle replacement systems done at a single institution over the same period of time.', 'Operative management of ever increasing ankle fractures in the elderly need a reliable system of internal fixation.', 'Lateral ankle ligaments augmentation using suture-tape showed the similar clinical outcomes but low cost-effectiveness, as compared to modified Broström repair for young female patients with chronic ankle instability.', 'Patients with first-time grade II lateral ankle sprain clinically diagnosed were evaluated (n=21).', 'Eighty-five medial malleolar ankle fractures were divided into 2 groups: group A included patients (n = 64) treated with malleolar screws and group B included patients (n = 21) treated with the sled device.', 'At a mean follow-up of eight years , seventeen patients ( twenty-one ankles ) had died and fifteen ankles had been revised because of aseptic loosening ( six ankles ) , primary or secondary axial deformity with edge-loading ( six ankles ) , deep infection ( two ankles ) , and a severe wound-healing problem ( one ankle ) , leaving fifty-seven ankles ( 61 % ) that were evaluated .', 'Fibula Rod System providing good stability and union, is a reliable operation for ankle fractures in the elderly.', 'To investigate the nature and extent of soft tissue ankle injuries, and to consider whether the anatomical severity of injury can predict functional outcome.']


Cluster  2316
['123 patients with AF were recruited, with 100 patients included in the final analysis.', 'The management of AF remains associated with many challenges that make its treatment a vexing problem .', 'The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto.', 'OSA is common and often undetected in patients with AF, especially in nonobese and/or female patients.', 'The study was a prospective randomized trial including 90 patients with persistent and longstanding persistent AF.', 'The primary objective is to compare the incidence rate of detected AF through 12 months of follow-up between the two arms.', 'OSA is underdiagnosed in a large number of patients with AF and may not be predicted by conventional clinical indices.', 'We validated the existence of a blood gene expression signature for prevalent AF and showed that biological age derived from gene expression is significantly associated with prevalent AF.', 'This prospective observational study included 30 consecutive patients with persistent AF.']


Cluster  1120
['Despite of the current achievements of medicine , the mortality of necrotizing pancreatitis ( NP ) is still too high -- up to 35 - 40 % and stands as a serious diagnostic and treatment problem .', 'There is a paucity of information on the epidemiology of acute pancreatitis (AP) in Australia', 'Acute pancreatitis ( AP ) is a serious , unpredictable clinical problem , the pathophysiology of which is poorly understood .', 'Acute pancreatitis is a serious surgical problem with a high incidence of mortality .', 'Due to difficulty in early diagnosis of chronic pancreatitis (CP), it is urgent to find novel biomarkers to detect CP', 'This prospective and observational study recruited a total of 102 SAP patients, 48 patients with mild acute pancreatitis and 102 healthy individuals.', 'Necrotizing pancreatitis is a serious medical problem that often requires intervention to debride necrotic pancreatic and peripancreatic tissue .', 'This imposes a serious concern on the genotyping of pancreatitis by a widely used polymerase chain reaction-restriction fragment length polymorphism assay , which could only detect the commonest c.365G > A variant .', 'Acute pancreatitis after delivery is a serious problem compared to other forms of acute pancreatitis .', 'Acute pancreatitis is a serious clinical problem .']


Cluster  340
['We conducted a multicenter randomized controlled trial conducted between June 2008 and May 2012: the DIVERTI (Primary vs Secondary Anastomosis for Hinchey Stage III-IV Diverticulitis) trial.', 'Ninety-four patients were randomized to laparoscopic Toupet or laparoscopic 180° anterior fundoplication (47 in each group).', 'A possible development of the postoperative persisting dysphagia , which decreases the quality of life of the operated , remains the main drawback of the laparoscopic antireflux surgery .', 'Cross-sectional observational study of randomized trials including patients undergoing gastrointestinal surgery published in a representative selection of general medical and general surgical journals.', 'A total of 193 patients were randomized and analyzed (intention-to-treat analysis), 97 in duct-to-mucosa and 96 in dunking group.', 'Some 80 patients were randomized, and 73 patients were evaluated in an intention-to-treat analysis: 36 in the pancreaticogastrostomy group and 37 in the handsewn closure group.', 'A double-blind RCT was conducted between 2012 and 2015 in two hospitals specializing in antireflux surgery.', 'Patients scheduled to undergo hepatectomy at the University of Tokyo Hospital or Nihon University Itabashi Hospital were eligible for this parallel-group, single-blinded randomized study.', 'Patients with proven GORD were randomized to laparoscopic Nissen or 180° anterior fundoplication.']


Cluster  462
['Maintaining adequate medical staffing in rural hospitals remains a serious problem .', 'Maldistribution of health professionals between urban and rural areas has been a serious problem in China .', 'Causes for health inequity among rural populations globally are multifactorial, and include poorer access to healthcare professionals', 'The need to recruit and retain health care providers remains a concern in rural communities', 'Disadvantages may outweigh benefits of AA care delivery in the rural ICU.', 'The geographical imbalance of the health workforce in Tanzania represents a serious problem when it comes to delivering crucial health services to a large share of the population .', 'A serious problem in rural areas is low occupancy for acute care hospital beds and a desperate need for additional long-term care beds .', 'The uneven distribution of medical resources is a serious problem in developing countries .', 'The objective of this study is to assess benefits of the acuity-adaptable (AA) care model in rural hospitals.', 'An unequal distribution of health personnel , leading to unfavourable differences in health status between urban and rural populations , is a serious cause for concern globally .']


Cluster  1887
['We collected clinical data from newborns who underwent perinatal DAT and from their mothers, between August 2008 and July 2017.', 'Cord blood samples from 31 PT and 17 term neonates were analyzed by flow cytometry.', 'Chromosomal mosaicism in amniotic fluid cells poses a serious dilemma in prenatal diagnosis since the observation may represent : ( 1 ) pseudomosaicism -- an inconsequential tissue culture artefact ; or ( 2 ) true mosaicism -- occurring in approximately 0.20 per cent of amniocenteses with a significant impact on pregnancy outcome .', 'Non-visualization of the fetal bladder during targeted sonography to evaluate oligohydramnios indicates a severe anatomic or functional problem of the fetal urinary tract .', 'As premature birth after fetoscopy remains a serious concern , an effort to reduce prematurity is required .', 'Data on the timing of catheter removal technique following embryo transfer (ET) are quite limited.', 'Venous umbilical blood was obtained from the placenta within 10\u2009min of delivery.', 'It must be considered a drawback of transcervical trophoblast aspiration that it is not possible to conduct alpha-foetoprotein determination or determination of acetylcholine esterase as part of prenatal neural tube diagnosis .']


Cluster  2251
['A total of 249 patients were included as part of the WEB-based distress program for implantable CARdioverter dEfibrillator patients (WEBCARE) study.', 'Patients needing an implantable cardioverter defibrillator ( ICD ) system , but without suitable access from jugular or subclavian routes present a vexing problem .', 'The frequent occurrence of ventricular tachycardia can be a serious problem for patients with an implantable defibrillator , and may necessitate adjuvant antiarrhythmic therapy or radiofrequency catheter ablation .', 'The totally subcutaneous implantable defibrillator (S-ICD) has been designed as a new alternative to conventional implantable defibrillators.', 'The frequent occurrence of ventricular tachycardia can create a serious problem in patients with an implantable cardioverter defibrillator .']


Cluster  1115
['The switch of medication led to an increase of ADRs such as reduced salivation (+11%), orthostatic dizziness (+11%), and sweating (+9.', 'However , since the loss of body weight was more marked in T-506 than in the other two drugs , the side effect was thought to be a serious problem .', 'During observation, there was no statistical difference between drug type and visual analog scale score change at 30 minutes, 90 minutes, or 4 hours, for either headache or nausea.', 'One problem associated with the assessment of drug effects on negative symptoms , however , is that drugs can act on both primary and secondary negative symptoms.(ABSTRACT TRUNCATED AT 250 WORDS )', 'The upstream postheparin ACT was significantly higher than the downstream postheparin ACT, with a mean difference of 24.', 'The MTD in part 1 was 0·075% based on a dose-dependent increase in the number and severity of adverse events.']


Cluster  409
['aPL titers were similar in the whole sample and in an apparently healthy subgroup of 1049 individuals.', 'Our data show that for IgM aPL, age-dependent reference ranges should be used.', 'Both groups had a similar mean follow-up duration (38.', 'Patients were equal at baseline.', 'All 102 patients enrolled were comparable for age (p\xa0= 0.', 'The total 72-hour AUC of cTnT (P\u200a=\u200a.', 'Sleep ( P ≤ 0.', 'The Richards-Campbell Sleep Scale indicated that while the experimental group had a mean score of 53.', "At baseline, the two groups' results were similar, with the exception being that the mean time to first out-of-bed mobilization after symptom onset was 51."]


Cluster  1560
['Conversely , perceiving drug dealing or drug use as a serious problem was associated with walking more frequently .', 'Opioid dependence , a severe addictive disorder and major societal problem , has been demonstrated to be moderately heritable .', 'During the 1970s the abuse of heroin and other opiates emerged as a serious problem of epidemic nature , predominantly affecting young people in many countries of South-East Asia .', 'Prescription drug abuse in Southwest Virginia is a serious problem affecting indi-viduals , families , and communities .', 'Heroin abuse is a serious problem that endangers human health and affects social stability .', 'The tensions surrounding methadone maintenance therapy ( MMT ) are outlined , as well as the sociohistorical context in which a serious heroin addiction problem in Ireland developed .', 'Black participants and those who believed that illegal drug use was a serious problem had greater odds of locking opioids ; participants with higher levels of education or who knew someone who used heroin or misused prescription opioids had lesser odds of locking opioids .', '[ NARCOTIC PRESCRIPTIONS AND THE PROBLEM OF DRUG ADDICTION IN SWEDEN . SHALL THE POLICE TAKE OVER THE ENTIRE MANAGEMENT OF A SERIOUS PROBLEM IN SOCIAL MEDICINE ? ] .']


Cluster  670
['Non-steroidal anti-inflammatory drug (NSAID)-induced gastropathy is a serious public health problem .', 'NSAID gastropathy is a serious , iatrogenic problem of common NSAID usage of major public health dimensions .', 'NSAIDs and self-medication : A serious concern .', 'The side effects of conventional non-steroidal anti-inflammatory drugs ( NSAIDs ) on the stomach is undoubtedly a serious public health problem contributing significantly to the morbidity and mortality of patients receiving these drugs .', 'Although non-steroidal anti-inflammatory drugs(NSAIDs ) , which are non-selective COX inhibitors , have been very often used as painkillers , their side effects such as gastrointestinal hemorrhage remain a serious problem .', 'Gastrointestinal ( GI ) toxicity is a major drawback of the chronic use of nonsteroidal anti-inflammatory drugs ( NSAIDs ) .', 'Although simultaneous use of several systemic NSAIDs has no pharmacological justification , this may raise a serious public health problem with the increasing use of over-the-counter non-steroidal anti-inflammatory agents .', 'Nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy is considered a serious and increasing clinical problem without available treatment .']


Cluster  1987
['In a placebo-controlled, double-blinded, randomized, crossover study two active treatments containing either TNC or lutein were assessed for their capacity to decrease the expression of UVA1 the radiation-inducible genes HO1, ICAM1 and MMP1.', 'Our findings suggest that daily oral almond consumption may lead to enhanced protection from UV photodamage by increasing the MED.', 'To examine the capacity of lycopene-rich tomato nutrient complex (TNC) and lutein, to protect against ultraviolet (UV)A/B and UVA1 radiation at a molecular level.', 'TNC completely inhibited UVA1- and UVA/B-induced upregulation of heme-oxygenase 1, intercellular adhesion molecule 1 and matrix metallopeptidase 1 mRNA, no matter the sequence (anova, P < 0·05).']


Cluster  1667
['The increasing incidence of A. baumannii is a serious concern , therefore control of this pathogen and taking preventive measures are emphasized .', 'The S. pn strains isolated from infant respiratory tract in Chengdu perform a serious drug resistance problem , especially to routine antibiotics like erythromycin , clindamycin and tetracycline and cephalosporin , the resistance rate to levofloxacin , chloramphenicol remained at a low level ; the resistance to tetracycline was closely related with the tet M gene fragment , the resistance to macrolide was mainly decided by active efflux pump and secondarily by the alternation of gene targeting , int Tn had close relation with tet M , erm B.', 'Presently , multidrug-resistant A. \xa0 baumannii is a serious health concern in hospitals and long-term care facilities and requires immediate and sustained prevention efforts to control the rate of incidence .', 'These observations suggest that if the carrier state results from intracellular GAS survival , the association between erythromycin resistance and intracellular persistence may represent a serious problem for the eradication of these isolates .', 'In recent years A.baumannii has become a serious clinical problem because of the development of resistance to many antibiotics , and especially to carbapenems .', 'Macrolide resistance of the B. pertussis population has been a serious problem in the northern part of China .']


Cluster  1480
['The impact of the microbiota on host fitness has so far mainly been demonstrated for the bacterial microbiome', 'Of interest , the vast number of studies demonstrates the role of microbiota in obesity , a serious public health problem that has reached epidemic proportions in many developed and middle-income countries .', 'There appears to be huge diversity of bacterial organisms in the oral cavity of stroke patients, and as most phylotypes identified were only found in one or two participants, no particular patterns linked to infection or the condition of the oral cavity could be discerned.', 'A total of 103 bacterial phylotypes were identified, 29 of which were not in the Human Oral Microbiome Database (HOMD).', 'The microbial composition of MW and CB differs in OLP.', 'The microbial composition differed between the MW and CB samples.']


Cluster  1960
['Peer education based on HBM is an effective strategy to promote preventive behaviors against pediculosis in among fifth grade female elementary school students in Iran.', "This study aimed to evaluate the effectiveness of a school-based intervention, delivered by teachers, in improving adolescent girls' FMS.", 'From 2014-2016 the Medical Society for Health Promotion carried out a unique project for gender-sensitive medical health promotion for boys of all school types at 130\xa0Bavarian schools.', "Results of the trial support the hypothesised positive impact of providing sanitary pads or puberty education for girls' school attendance in a developing country context.", 'Teachers adequately trained in authentic assessment and student-centered instruction can significantly improve the FMS competency of early adolescent girls.']


Cluster  894
['Results show clear evidence that the exposure to the game-like simulation had a significant positive effect on all the constructs.', 'We aimed to examine the effectivity of a guided ICBT combined with a serious gaming intervention in improving self-reported psychophysiological and immunological health endpoints in response to psychophysiological and immune-related challenges .', "SBT and Tetris were feasible as home-based interventions, and participants' compliance was high, but participants perceived both interventions as not very interesting or helpful.", 'The analysis of psychological observation forms and game protocols, which were conducted over a period of 3 months, indicated different effects of the game on psychosocial and cognitive activation.', 'A major drawback of existing health games is that they are not very well described and attributed with ( machine-readable , quantitative , and qualitative ) metadata such as the characterizing goal of the game , the target user group , or expected health effects well proven in scientific studies .']


Cluster  200
['MSNA, clinical variables, and parameters of central blood pressure (BP) and arterial stiffness were collected in 18 NYHA Class III HFrEF patients, nine receiving BAT and nine continuing with optimal medical management alone.', 'Reduced HRV is common in ATTRm amyloidosis patients during DB, however, autonomic function cannot be evaluated in patients presenting with the combination of "normal" scores and low regularity, since their HR responses often reflects dysrhythmias.', 'Patients with RBBB, left axis deviation, and no prior anterior MI may have LV dyssynchrony between the anterior and inferior walls that is correctable with CRT.', 'Patients with RBBB + LAFB demonstrated baseline echocardiographic dyssynchrony between the LV anterior and inferior wall.', 'Between February 2013 to April 2016, association of HR reduction with haemodynamic indices, motor function and QoL in CHF patients with HR>80bpm receiving metoprolol 23.', 'Despite significant reductions in MSNA and clinical improvement, BAT does not appear to chronically modify arterial stiffness within this HFrEF cohort.', 'The riser BP pattern was found to be a novel predictor of cardiovascular outcome in HFpEF patients.', 'Bradyarrhythmic events are frequent in patients with FD and are associated with LA dysfunction.', 'PAPP, a novel parameter for right-sided proportional pulse pressure, is an independent and powerful predictor of adverse clinical outcomes in advanced HF.', 'Bradyarrhythmia are common manifestations of cardiac involvement in FD.']


Cluster  808
['Suicide is an under attended public health problem in Bangladesh as there is no central suicide database and no national suicide surveillance system in the country', 'Regional disparity in suicide rates is a serious problem worldwide .', 'Suicidal behavior is a severe problem among drug users .', 'The prevalence of Korean adolescents with depression was 25.1 % in 2017 , and the suicide rate among Korean teens increased from 4.2 deaths per 100,000 in 2015 to 4.9 deaths per 100,000 in 2016 , suggesting that a high prevalence of depression and suicide among adolescents is a serious social problem in South Korea .', 'Earlier studies among the other main ethnic groups in the country showed suicidal behavior in those groups to be a serious problem .', 'Suicide is a serious social problem in many countries , including Japan .', 'India is experiencing increasing suicides that have much economic impact', 'Suicide is a serious problem in East Asia . Yet , there is a significant lack of research on the topic , particularly using qualitative methodology .', 'Although suicide-related outcomes among Asian American adolescents are a serious public health problem in the United States , research in this area has been relatively sparse .', 'Suicide is a serious public health concern worldwide , and the fourth leading cause of death in Korea .', 'Substance abuse is a serious and major public health problem in Iran and potentially increases the risk of suicidal behavior ; therefore , it is essential to increase our knowledge concerning the etiology of suicide among individuals with substance use disorders .', 'However , the findings did confirm that suicide exists as a serious problem in the society in Kurdistan , particularly among females .', 'The crisis level in the worldwide suicide rate has revealed a severe suicide problem in Taiwan that is now well above the world average of 16 per 100,000 individuals .']


Cluster  1134
['Bacterial attack is a serious agricultural problem for growth of rice seedlings in the nursery and field .', 'Panicle blight of rice , caused by Burkholderia glumae , has been a serious problem on rice in Japan since 1955 .', 'Rice blast disease is a major restriction in rice production', 'Magnaporthe oryzae is the causal agent of rice blast disease , a devastating problem worldwide .', 'The presence of these organisms in economically important rice strip farming is a serious food safety concern .', 'Bacterial blight caused by the infection of Xanthomonas oryzae pv . oryzae ( Xoo ) is a devastating disease that severely challenges the yield of rice .']


Cluster  1025
['Recognizing this impaired perception as a serious ecological problem has been undermined by the fact that the damage is often reversible ; short depuration periods of 5 d may allow for the re-establishment of responses to chemical cues .', "Here , the term SHOCK ( Sudden , High-magnitude Opportunity for a Catastrophic ' Kick ' ) is used to encompass attributes of extreme events that carry the potential to add additional challenges to insect communities already facing environmental stressors .", 'Increased salinity in rivers and streams is a serious environmental concern , and in Australia there is growing information about the acute tolerances to salinity for freshwater macroinvertebrates , but much less information about chronic and sub-lethal tolerances .', 'Populations that have passed through a severe bottleneck can show a markedly reduced ability to respond to change , particularly in the face of novel challenges .', 'The results confirm that those who habitually worry about the ecology are not only lacking in any psychopathology , but demonstrate a constructive and adaptive response to a serious problem .']


Cluster  1733
['The time to heat the milk from room temperature to 58°C was 12.', 'Fouling of plate heat exchangers ( PHE ) is a severe problem in the dairy industry , notably because the relationship between the build-up of protein fouling deposits and the chemical reactions taking place in the fouling solution has not yet been fully elucidated .', 'The milk temperature during each phase of the pasteurization cycle was recorded using 6 to 9 probes, depending on the number of bottles, in the pasteurizers.', 'Human milk treated using the air pasteurizer in our study was exposed to higher temperatures and for longer periods of time than the water pasteurizers we employed.', 'Thermal stable proteases may constitute a serious problem to ultra-high temperature ( UHT ) processed milk , leading to undesirable physical and sensory alterations .', 'Light-induced degradation reactions in milk create a serious problem for the dairy industry because of the development of off-flavors , the decrease in nutritional quality , and the severity and speed by which these phenomena develop .']


Cluster  723
['By the twentieth century , infectious diseases had become a serious concern , and the need to carry out screening and conduct post-mortem examinations resulted in the appointment of a pathologist , whose main role was to conduct biological and histological examinations to identify cases of tuberculosis , syphilis , dysentery , typhoid , influenza and other bodily diseases .', 'In Poland each year between the first and the second world war typhoid fever was a serious sanitary problem .', 'Ancylostomiasis is a serious public health problem that negatively influences health and hinders socioeconomic development .', 'Infectious diseases are a serious social problem .', 'On the other hand , though sporadic , outbreaks of endemic diseases together with HIV-TB coinfection and infection with drug resistance microbes during recent years have constituted a serious public health as well as medical problem .', 'Nevertheless , one should not forget that these infections still pose a serious public health problem and can elicit severe disfigurement or death in the individual .', 'After then , BSE became a serious social problem all over the world .', 'Among them , infestation by leeches is a serious problem in the Himalayan belt of Northeast India .', 'The disease is a serious public health problem , and is directly linked to social issues .', 'Smallpox was a serious public health problem , and typhoid fever , pneumonia , and tuberculosis continued to cause high mortality .', 'Therefore , chronically infected people should perceive it as a serious health problem and move on to appropriate health behaviour .', 'Envenomations constitute a serious public health problem in many developing countries .', 'For example : ( i ) a child dies in Africa every 30s due to malaria-a disease related to stagnant water , ( ii ) every year flooding causes many deaths world-wide , with infant mortality due to diarrhea from contaminated flood waters posing the biggest threat , and ( iii ) poor sanitation and its relation to hepatitis A continues to be a serious problem .', 'However , it is still a serious problem among health workers who are an important risk group to acquire this infection .', 'In the 1930s , veneral disease was identified in Newfoundland as a serious public health problem .', 'If this issue is not resolved , it may cause a shift back to the pre-antibiotics era and infectious disease will again be a serious problem , especially in developing countries .', 'Their epidemic outbreaks become a severe problem not only in healthcare , but also in economical and social spheres .', 'Some of these ( malaria , toxoplasmosis , leishmaniosis , dirofilariosis , alveococcosis , cystic echinococcosis ) still represent a serious public health problem in many regions in the world .', 'The disease appeared as a serious problem and the leading cause of death in human beings throughout the world .']


Cluster  1039
['Semi-structured interviews with key informants followed by an observational study involving GPs in the UK.', "Four focus groups were conducted based on Krueger's methods in conducting focus groups: two with Vinland staff members and two focus groups with residents.", "This randomised controlled trial assigned first-year students from the University of Bern, Switzerland, to either an interview with a chronically ill patient at the patient's home or to a sham comparator.", 'Qualitative data were collected through in-depth semi-structured interviews with 15 patients and a focus group of 8 therapists.', "Even though the importance of a facilitator during an implementation process is well described, the facilitator's role is rarely problematized in relation to the organizational context in terms of power and legitimacy; themes which have recently been brought to the fore when studying change in health care organizations.", "Many of the themes evolved in relation to the subjects' contact with the healthcare services they received, but when the themes were merged and structured into the model, a cohesive pattern of empowerment appeared.", 'Qualitative study in a controlled clinical trial.', 'A qualitative focus group was conducted with eight staff members (five health educators and three health interviewers) involved in Proyecto Mamá and Estudio Parto.', 'A single-center cross-sectional observational study whereby 16 semistructured interviews were held with selected health care professionals focusing on perceived effects and underlying mechanisms.', 'A structured electronic questionnaire was developed following qualitative phase for semantic formatting, and was administered to volunteer women in ten Brazilian cities.']


Cluster  449
['A total of 5766 and 4272 adults were categorized as having mild and severe AD, respectively.', 'The trial was a 12-week, randomized, assessor-blinded, crossover, prospective, cohort study of 39 patients with mild-to-moderate AD, aged between 4\xa0weeks and 3\xa0years, comparing superfine merino wool ensembles with standard cotton clothing chosen by parents.', 'This study examines the effects of superfine merino wool on symptoms in participants with mild-to-moderate AD.', 'Serum SCCA2 levels reflected disease severity and clinical type of AD.', 'A major problem with most active and passive immunization approaches for AD is that both the normal sAβ and pathogenic forms are equally targeted with the potential of autoimmune inflammation .', 'We sought to examine the prevalence and risk of selected ocular comorbidities in adult patients with AD.', 'Patients with AD showed hypersensitivities against MGL_1304 and its homologs.', 'The aim of this study was to identify and quantify skin CER subclasses in association with disease severity in pediatric patients with AD.', 'Forty-two eligible patients with AD were recruited.']


Cluster  1520
['The clinical efficacy of ingenol mebutate on AKs is confirmed by its effect on angiogenesis, stem cell activity and cell proliferation in vivo.', 'Very low systemic exposure to ingenol disoxate was observed when applied to the face, arm, or scalp in patients with AK under maximum-use conditions.', 'Ingenol mebutate ( IM ) , a novel agent for field therapy of actinic keratosis ( AK ) , has a drawback of inducing local skin reactions ( LSRs ) , which may cause discomfort in patients .', 'Ingenol mebutate achieves histopathological clearance of AKs that correlates with observed clinical clearance.', 'Ingenol disoxate (LEO 43204) is a field therapy in development for the treatment of actinic keratosis (AK) on areas between 25 and 250\xa0cm<sup>2</sup>.']


Cluster  
IOPub data rate exceeded.
The notebook server will temporarily stop sending output
to the client in order to avoid crashing it.
To change this limit, set the config variable
`--NotebookApp.iopub_data_rate_limit`.

Current values:
NotebookApp.iopub_data_rate_limit=1000000.0 (bytes/sec)
NotebookApp.rate_limit_window=3.0 (secs)

2216
['The measurement of skin impedance of the upper and lower limbs and torso in individuals with chronic neck pain has acceptable reliability values when considered at different times and by different examiners.', 'Skin impedance is a biological signal that has been employed in the measurement of pain.', 'To examine the intra- and inter-rater reliability of skin impedance measurement in individuals with chronic neck pain.']


Cluster  391
['To evaluate the effect of audiovisual distraction on behavior and self-reported pain of children with special healthcare needs (SHCN) without intellectual disability during dental restorations and its influence on the operator stress and the time of the appointment.', 'Substance abuse by adolescents is a serious problem that will touch every orthodontic practice .', 'There is significant improvement in the countenance of patients after orthognathic surgery, with both perceived personality traits and emotions deemed more favorable.', 'The ART-based approach to managing ECC resulted in similar levels of dental anxiety to the standard treatment approach and provides a valuable alternative approach to the management of ECC in a primary dental care setting.', 'Heart rate, Facial Image Scale (FIS), and Venham-6-point index were used before intervention, after intervention, and during dental procedure to quantify the anxious behavior.', 'The use of video eyeglasses significantly reduced the operator stress.', "Dental anxiety is a serious problem that influences both mental and physical patient 's health .", 'Stress : a serious problem in dentistry .', 'The interest in the psychological aspects of orthodontic treatment increases , but a drawback of many studies is that the psychological characteristics of the children themselves are often ignored .', 'Audiovisual distraction using video eyeglasses is useful in managing distress and reducing fear and anxiety in healthy children during dental treatments.', 'Children with ECC were randomized to test (atraumatic restorative treatment (ART)-based approach) or control (standard care approach) groups.']


Cluster  1090
['Furthermore , one possible drawback in employing this bootstrapping method is that there may be a complementary distribution between prosodic and lexical features', 'In turn , there is a loss of independence from linguistic knowledge , when compared to shallower approaches . its apparent inadequacy in dealing with the sparse data problem', 'Another limitation that was discovered after the data analysis was that a data input error caused All Negative Chinese n-gram category to be combined with two n-grams included in the Positive Chinese School and Home category', 'The main drawback is the strong confidence this approach places on word boundaries ( Beaufort et al. , 2010 )', 'To account for such effects in the data , we augment A0 with a set of n fixed , manually defined features -LRB- e.g. a data input error caused All Negative Chinese n-gram category to be combined with two n-grams included in the Positive Chinese School and Home category', 'A weakness of the method is that poor results are obtained for language pairs that are not closely related ( Ismail and Manandhar , 2010 )', 'In turn , there is a loss of independence from linguistic knowledge , when compared to shallower approaches . its apparent inadequacy in dealing with the sparse data problem']


Cluster  2036
['In all, 46 patients remained alive at 30 days after surgery.', 'Out of 153 patients, 28 died; 28% of the survivors had a Glasgow Outcome Scale 3 or less and 13% were discharged to dependent care.', 'Thirty days after surgery, mortality was 36% for patients with intervention vs 31% for controls (P\xa0=\xa00·32).', 'Disease progression and death were confirmed in 37 and 27 patients in follow-up periods, respectively.', 'Despite the progress in the management of the disease, about one in four hospitalised patients dies and four in ten are rehospitalised in less than one year.', 'From 273 eligible patients, we received data from 135 patients, 9 of them died during the follow-up time at the median age of 46years (range 30-64years).', 'Fifty percent of all patients were hospitalized, and 32% died during the follow-up period.']


Cluster  1255
['In both sexes, TLT showed better sensitivity and specificity than ASM for MetS diagnosis.', 'High prevalence of MetS especially among overweight and obese adolescents is a serious health problem .', "Three novel markers-LAP, VAI and TG/HDL-C ratio could be effectively used as a single 'Surrogate marker' for screening of asymptomatic Gujarati Asian Indians with MetS."]


Cluster  996
['Manganese ( Mn ) pollution in soil , especially around the mining areas , is a severe problem in China .', 'Nowadays , Mn(II ) contamination has become a serious environmental problem in some regions of the world .', 'In the summertime , the manganese pollution in moderately deep lakes and reservoirs caused by thermal stratification processes has been a serious problem .', 'However , after mushroom harvesting , the disposal of spent mushroom substrates ( SMSs ) is a serious problem for the mushroom industry owing to the need for a disposal site and the cost involved .', 'In conclusion , heavy metal pollution in wild edible mushrooms is a serious problem in the Yunnan Province .']


Cluster  2158
['Success of both surgical interventions remained high at the 10-year interval.', 'Data retention was high (100% data completion at posttreatment for primary outcome, 96% at 6-month follow-up and 94% at 12-month follow-up).', 'Our results showed a consistent recovery with little caregiver burden at discharge.', 'The treatment was well tolerated.', 'Most of patients had satisfactory therapeutic response, in terms of GAGs reduction.', 'After 12 months of follow-up, the restorations were considered clinically successful in 89.']


Cluster  1709
['Temporomandibular joint ( TMJ ) ankylosis is a serious problem that restricts jaw mobility and causes disturbances in facial and mandibular growth .', 'A total of 30 patients suffering from internal derangement of TMJ were selected for this study.', 'A prospective study was carried out for evaluation of efficacy of TMJ arthrocentesis with and without injection of SH in management of internal derangements.', 'A total of 44 patients radiographically diagnosed with non-reducing disc displacement of the temporomandibular joint (TMJ) were randomly divided into four treatment groups, as follows: Group 1, arthrocentesis alone; Group 2, arthrocentesis plus methylprednisolone acetate; Group 3, arthrocentesis plus sodium hyaluronate; Group 4, arthrocentesis plus tenoxicam.']


Cluster  570
['Sulfate-reducing bacteria ( SRB ) pose a serious problem to offshore oil industries by producing sulfide , which is highly reactive , corrosive and toxic .', 'The main hazard was found to be high transient concentrations of hydrogen sulphide presenting in some cases a serious acute toxicity problem .', 'The biogenic production of hydrogen sulfide is a serious problem associated with wastewater treatment .', 'In 2008 , 1,007 cases of suicide in which hydrogen sulfide was used as a suicidal agent were reported in Japan , and this has become a serious social problem .', 'Pollution of antimony ( Sb ) raises a serious environmental problem .', 'Their disposal represents a serious environmental problem ; however , SCG could be valorized within a biorefinery concept yielding various valuable products .', 'SRB can cause a serious problem for industries , such as the offshore oil industry , because of the production of sulphide , which is highly reactive , corrosive and toxic .']


Cluster  2246
['These sensors generally work in a severe environment , so the key problem for sensor data acquisition is to ensure data accuracy and reliability .', 'Traditional acquisition sensors are CCD cameras , which cause a serious heating problem and call for high alignment precision .', 'The developed sensor rarely suffers from a drawback of impurity adsorption .', 'For the MEMS capacitive accelerometer , parasitic capacitance is a serious problem .']


Cluster  1920
['Sixty one patients were enrolled in the study.', 'Fifty patients were included in the study.', 'In total, 60 patients participated in this study.', 'Fifty-one (51) patients were included in the study.', 'Fifty subjects completed this study.', 'A total of 60 patients were included in this study.', 'A total of 64 patients were included in our study (71.', 'Sixty-eight patients were included in the study.', 'The trial included 58 patients.']


Cluster  1871
['Suicide is rarely discussed in primary care encounters in the context of depression treatment.', 'The relatively small percentage of unimplemented psychotherapeutic treatment is surprising at a\xa0first glance.', "On the patients ' side , sometimes sufferers do not notice the symptoms of depression by themselves , which may also be a serious problem .", 'Underrecognition and undertreatment of affective disorders constitute a serious public health problem in this country .', 'Underdetection and undertreatment of depression is a serious problem in palliative care .', 'Underrecognition and undertreatment of affective disorders ( i.e. , major depressive disorder and bipolar affective disorder ) constitute a serious public health problem in this country .', 'The results of this study suggest that apathy is a severe problem in KS .']


Cluster  1450
["Treatment satisfaction can be improved by integrating patients' preferences into shared decision-making.", 'More than 90% of patients and physicians voted for shared decision making or an informed choice decision making approach.', "Fifty percent of patients agreed with the statement that a potential problem with advance directives was that patients could change their minds about heroic treatments ; 51 % agreed that advance directives might interfere with a doctor 's judgment .", 'A nurse, as the main subject of decision-making in clinical settings, experiences various situations that require communication with a range of health care providers', "Patients' preferences for biologicals vary in correlation with treatment experience and disease duration, aspects to be addressed in the context of shared decision-making.", 'Shared decision-making may not be the norm in hospital care.']


Cluster  1790
['The long polarization build-up times of typically more than one hour are a drawback of this technique .', 'Nevertheless , a drawback of these sequences is that they require specific adjustment of the frequency offset or the time interval between pulses ( Tp ) .', 'However , a drawback of this technique is that it requires lengthy rest periods in between inversion groupings to allow for complete magnetization recovery .', 'This study confirms good early results after RSA after more than 5\xa0years.', 'However , a drawback of MTA is its long setting time .', 'A drawback of these sequences is their high sensitivity against small perturbations of the magnetic field , caused , e.g. , by differences in magnetic susceptibility of soft tissue , bone and air .', 'A major drawback of eNpHR3.0 is related to its pronounced inactivation on a time-scale of seconds , which renders it unsuited for applications that require long-lasting silencing .', 'A major drawback of the novel sequences is their limited sensitivity .']


Cluster  1550
['Child firesetting constitutes a serious and widespread problem , yet little definitive evidence exists distinguishing child firesetters from their nonfiresetting peers .', 'The fire is a tragic demonstration of shortcomings in hazardous material management and emergency response .', 'A serious concern in the peer-reviewed literature is a lack of evidence of environmental monitoring of either occupational or non-occupational exposures during fumigation .', 'Though several specific work operations were identified , the episodic nature of carbon monoxide poisonings , as well as the diverse industries and sources , and the opportunity for a severe poisoning in any number of operations , poses challenges for effective intervention .', 'Occupational exposure to welding fumes is a serious occupational health problem all over the world .']


Cluster  2188
['Prospective observational study of 727 patients with skin cancer who self-reported QOL via the Skin Cancer Index immediately before and at 1 to 2\xa0weeks and 3\xa0months after MMS.', 'In a matched, nationwide, population-based cohort study, we compared the risk of skin cancer in 4280 patients with HIV from the Danish HIV cohort study with a background population cohort, according to the level of immunosuppression and route of transmission.', 'Data from occupational skin cancer screenings were analysed in a cross-sectional study.', 'Skin cancer in organ transplant recipients is a serious problem that manifests as increased squamous cell carcinoma in longterm patients .', 'Seven patients with a total of 47 cutaneous metastases from breast cancer and malignant melanoma were included in the protocol.', 'The results of this study indicate that genital tract and breast cancers constitute a serious public health problem pointing out the importance of screening activities in the Somme area .', 'Seventy-one patients scheduled for skin cancer excision at Beverly Hospital were included in this prospective, randomized, single-blind study.']


Cluster  271
['Learning curves are inescapable in modern medicine.', 'Brain diseases affect millions of people worldwide , and this number will grow as the size of elderly population increases , thus making brain disease a serious public health problem .', 'Neuroscience is now promising significant advances in medical practice, such that it can improve the art and science of personalized medicine', 'This raises a serious concern considering the enormous burden that neurological diseases may constitute in our environment .', 'Large-scale research on Pavlovian conditioning and weight control is needed because verification could result in easy and inexpensive mitigation of a serious public health problem .', 'This progressively determines nervous dysfunction and onset/progression of neurodegenerative diseases , which represent a serious social ( and economic ) problem of our populations .']


Cluster  470
['Among 294 included patients, mTR and mNR independently predicted prognosis before surgery.', 'Our aim was to evaluate the predictive values and the most powerful predictive combinations of single aEEG and NIRS parameters and the respective cut-off values with regard to short-term outcomes in HIE II.', 'A prospective study of 30 SNRBs was conducted.', 'We developed a CSDH grading system to predict RrR based on predictive characteristics that can be objectively assessed at the time of first presentation and initial surgery.', 'In HIE II, aEEG and NIRS are important predictors of short-term outcome.', 'Twenty-four SNRBs were performed at L4-5 and 6 SNRBs at L3-4.']


Cluster  1080
['Subjects undergoing MMS were randomly assigned to the control (n\xa0=\xa010) or study arm (n\xa0=\xa014).', 'RRMS patients earned almost twice as much as PPMS and SPMS patients (on average SEK 204,500, SEK 114,500, and SEK 79,800 in 2010, respectively).', 'Participants undergoing MMS received 2.', 'Our findings argue for similarities between PPMS and SPMS and highlight the socioeconomic importance of preventing RRMS patients convert to SPMS.', 'Sixty patients diagnosed with MPS in the LPM were selected and randomly assigned to one of three groups.']


Cluster  1232
['An excellent introduction to the broad field of mathematics , each chapter written by one of the masters of the field , is Newman -LRB- 1988 -RRB- . it required a dependency parser , thesaurus , and training data', 'An excellent introduction to the broad field of mathematics , each chapter written by one of the masters of the field , is Newman -LRB- 1988 -RRB- . it required a dependency parser , thesaurus , and training data']


Cluster  1101
['In the present study, we aimed to investigate the effects of Shaker exercise on aspiration and oral diet level in stroke survivors with dysphagia.', 'To investigate the effect of resistance EMST on the swallowing function in stroke patients with oropharyngeal dysphagia.', '- Characterize the life quality of the elderly swallowing affected by stroke.', 'As the first study in literature, we aimed to evaluate the effects of sensory-level electrical stimulation (SES) to bilateral masseter muscles in early stroke patients with dysphagia.', 'This study investigated the effect of CTAR on the swallowing function in patients with dysphagia following subacute stroke.', "This study aimed to identify the effect of effortful swallowing combined with neuromuscular electrical stimulation as a novel treatment approach in dysphagic patients with Parkinson's disease.", 'SES applied to bilateral masseter muscles may provide an effective treatment for both dysphagia and cognitive function in early stroke patients.']


Cluster  1534
['Fibromyalgia syndrome (FMS) is a rheumatic disorder that presents with physical, psychological and social symptoms.', 'A significant number of fibromyalgia patients do not respond adequately to the current drugs approved by the Food and Drug Administration (FDA) for fibromyalgia treatment including pregabalin, milnacipran, duloxetine.', 'Two small prospective pilot studies have previously shown that treatment with low dose naltrexone may be an effective, safe, and inexpensive treatment for fibromyalgia.', 'ConclusionFibromyalgia is a chronic pain disorder characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance and cognitive impairment.']


Cluster  2290
['The significantly greater width of the facial nerve trunk in LM patients older than 1 year than those younger than 1 year suggests that the age of 1 may be a threshold for facial nerve hypertrophy and growth acceleration.', 'Despite the high incidence of postoperative facial paresis at 1 week, its magnitude was low and the recovery time was short.', 'Facial nerve paralysis is a devastating problem for those affected .', 'Prospective and descriptive clinical study on 79 patients undergoing formal superficial parotidectomy with the modified facelift incision, dissection of the facial nerve and reconstruction with the superficial musculoaponeurotic system flap.', 'Peripheral facial paresis is a serious clinical and social problem .']


Cluster  1837
['Eight volunteers performed two no-decompression dry dives breathing air or EANx for 20 min at 0.', 'Decompression sickness affecting the nervous system is still a serious problem in diving , but the mechanisms involved are in dispute .', 'Increasing ambient pressures do present a serious problem to BH deep divers , because the semi-rigid thorax prevents the deformation required by the Boyle-Mariotte law .']


Cluster  235
['The nonselective beta-blocker propranolol is the current criterion standard for treatment of infantile hemangiomas (IHs) and the first therapy that the U.S. Food and Drug Administration has approved for the condition, but concern about adverse effects, such as bronchospasm, hypoglycemia, and sleep disturbances, has sparked interest in the use of alternative agents such as the selective β1 antagonist atenolol.', 'Infantile hemangiomas (IH) are the most common benign vascular tumors in childhood.', 'Primary Hepatic Epithelioid Hemangioendothelioma is an extremely rare tumor of vascular origin', 'Left ventricle (LV) lipoma is a very rare, benign cardiac tumor', 'Monocentric, retrospective, observational study included infants with infantile hemangiomas treated with oral propranolol between August 2014 and May 2017.', 'Polyangiomatosis is a great rarity , and in view of the similarity to metastatic tumours , it is a serious diagnostic problem .', 'Compared with small-sized pheochromocytomas, laparoscopic resection of medium-sized pheochromocytomas requires vigilant monitoring and resolution of hemodynamic fluctuations.']


Cluster  2387
['To evaluate the long-term effects of intense pulsed light (IPL) combined with meibomian gland expression (MGX) in the treatment of meibomian gland dysfunction (MGD).', 'To determine the efficacy and safety of intense pulsed light (IPL) applied directly on the eyelids and meibomian gland expression (MGX) in treating meibomian gland dysfunction (MGD).']


Cluster  2348
['The high capacity of Escherichia coli to form populations resistant to anti-microbial medications , including pan-resistant ones , also is a serious problem for science and public health .', 'We conclude that there is a high prevalence of E. faecalis in UTI cases with a 100 % MDR rate indicating a serious problem in treating infections by this organism in Egypt .', 'Escherichia coli ( E. coli ) urinary tract infections ( UTIs ) are becoming a serious problem both for pets and humans ( zoonosis ) due to the close contact and to the increasing resistance to antibiotics .', 'The rising incidence of urinary tract infections ( UTIs ) attributable to Escherichia coli resistant isolates is becoming a serious public health concern .', 'Recently , wide spreading of fluoloquinolone resistant Escherichia coli is a serious problem inthe treatment of urinary tract infection .', 'The rising incidence of urinary tract infections ( UTIs ) attributable to Escherichia coli resistant isolates is becoming a serious public health concern .']


Cluster  1915
['Hepatitis B has long been a serious public health problem in Greece .', 'HBV and HDV infection is still a serious health problem in Southeastern Turkey .', 'This result may be related to the lower socioeconomical status of Sanliurfa ( which is located in Southeast Anatolia ) , and indicates that HBV should be considered as a serious public health problem in East and Southeast parts of Turkey .', 'There are large age-group and regional differences in CHB prevalence in Turkey , where CHB remains a serious health problem .', 'A prospective, randomised controlled trial conducted in the Eastern Turkey.']


Cluster  2131
['Statistically significant HRQoL improvements were seen in all measures in both treatment groups (p\u2009<\u20090.', 'The results of this study demonstrate that 6-month intervention of NPMP increased HRQOL and self-esteem as well as reduced pain.', 'To investigate whether treatment of AK improved HRQoL; to assess whether LSRs had an impact on HRQoL during treatment and to analyze the relationship between LSRs and HRQoL.', 'A significant reduction in HR and an increase in HRV at post- and 3-month post-intervention was noted (χ22=\u200a8.', "The WHHIP demonstrated the ability to improve participants' mood, sleep and sodium intake over time."]


Cluster  2300
['Few studies have compared bilateral same-day with staged tympanoplasty using cartilage graft materials.', 'Surgical outcomes are not significantly different for same-day and bilateral cartilage tympanoplasty, but same-day surgery has the added benefit of a lower cost.']


Cluster  1969
['In NER track we also include a named entity list extracted from the training data . the CCG labels for a particular sentence significantly reduces the paraphrases that can be used', 'In NER track we also include a named entity list extracted from the training data . the CCG labels for a particular sentence significantly reduces the paraphrases that can be used', 'In NER track we also include a named entity list extracted from the training data . the CCG labels for a particular sentence significantly reduces the paraphrases that can be used']


Cluster  1637
['Our learned policy outperforms the monotone policy toward the end and of course outperforms the batch policy throughout the sentence . if the web site being queried is modified by its creators , slight modifications will have to be made to the query generator to accommodate those changes', 'Training starts in a noise free environment using a small number of grid points and it continues until the performance of the policy levels off . it queries each term appearing in each list and hence , suffers from high run time cost', 'Indeed , learning the solution with Partially Observable MDPs in a batch and off-policy manner is not common in the literature . word co-occurrence information is not sufficiently exploited', "One of the main goals of SLA modeling is to discover which input is most effective for SLA , because a substantial part of learners ' input can be controlled , while their time capacity is small . the large combined search space", 'While previous work has shown that adapting LMs based on the input improves SMT performance , none of the techniques has thus far been shown to be feasible for on-line systems . it does not have a mechanism for attaining the maximize margin of the training data', 'Training starts in a noise free environment using a small number of grid points and it continues until the performance of the policy levels off . it queries each term appearing in each list and hence , suffers from high run time cost']


Cluster  2223
['We enrolled 105 ICH patients and 105 healthy individuals.', 'Among 74 283 patients with ICH from 1358 hospitals, 5929 (7.', 'Patients admitted between April 1997 and June 2013 with ICH diagnosis were evaluated for inclusion and exclusion criteria.']


Cluster  1004
["Those changes may be a serious problem not only for the patient 's health but also their aesthetics .", "Furthermore , even if hair colour change is not a life-threatening side effect , it is of deep concern for patient 's quality of life and adherence to treatment .", 'The problem with this practice is that the options recommended in overseas guidelines are not necessarily suitable for Japanese clinical practice .', 'There is great variability in resources and current practices and no "standard of care" exists.', 'Any deviation from normal values is a serious clinical problem .', 'However , when sample size is sufficiently large , a slight deviation from normality would not be a serious problem .']


Cluster  194
['We further discuss the method of phase shift estimation in the presence of tau-changes , because such changes pose a serious methodological problem in the estimation of phase shifts .', "Because the Earth 's rotation may cause bad phase restoration , we face a serious problem : how to transfer incoherent radiation to remote satellites .", 'The problem with such peaks is that the method that is generally considered to be the only mathematically correct method ( i.e. , the method of moments ) leads to peak variance values that are so strongly dominated by the tail of the peak that they become highly exaggerated and practically meaningless ( i.e. , they are dominated by the peak width at 10 or 12σt , which corresponds to resolutions and peak purities that are so high they are never pursued in practice ) .', 'However , a key drawback of SCRS is the fact that spontaneous Raman signals are naturally weak ; this review discusses recent research progress in significantly enhancing and improving the signal of spontaneous Raman spectroscopy , including resonance Raman spectroscopy ( RRS ) , coherent anti-Stokes Raman spectroscopy ( CARS ) , stimulated Raman spectroscopy ( SRS ) and surface enhanced Raman scattering ( SERS ) .', 'A common problem during study of , for instance , tensile tests with interferometers is that the sample moves too much so that the speckles decorrelate and no phase information is obtained .', 'Finally , we discuss the nascent developments of spatially heterodyne spectroscopy , a method that seeks to circumnavigate a serious drawback of most spectrometers - very small optical throughput - through the use of interferometers .', 'Generalized estimating equations of relative alpha power revealed a significant effect of period was identified at O2 (P=.', 'The instrumentation setup consisted of a light source, a fiber-optic contact probe, and two spectrometers connected to a computer.', 'This method , called PSF-Choice , is particularly relevant for applications , such as spectroscopic imaging , in which only a very few phase encodes are acquired and ringing artifact can be a serious problem .']


Cluster  2279
['A major drawback of the system was the resolution of the resulting pictures that was lower than conventional digital cameras .', 'Overall , the relatively low performance of resolution', 'The main problem with JPEG compression is that the same pixels , after moving to a different position and storing in the JPEG format , have different values .']


Cluster  2094
['By these prefixation , the root is reduplicated as given below : the independence between many choices can not be fully exploited', 'By these prefixation , the root is reduplicated as given below : the independence between many choices can not be fully exploited']


Cluster  2079
['Enterohemorrhagic Shiga toxin (Stx)-producing Escherichia coli ( EHEC ) infections are a serious public health problem , and Stx is the main pathogenic agent associated with typical hemolytic-uremic syndrome ( HUS ) .', 'Shiga toxin-producing Escherichia coli ( STEC ) are zoonotic foodborne and waterborne pathogens that are a serious public health concern because they cause outbreaks and the potentially fatal hemolytic uremic syndrome ( HUS ) .', 'Infections with shiga toxin-producing bacteria , like enterohemorrhagic Escherichia coli and Shigella dysenteriae , represent a serious medical problem .']


Cluster  1360
['Compared with non-clonal anemia, the PSDCs and ISDs of the four specific dysplastic types as petal nucleus and internuclear bridging in erythroid lineage, pseudo-Pelger-Huet in granulocytic lineage and lymphoid small megakaryocyte in megakaryocytic lineage were significantly higher in MDS; and their area under the curves were all greater than 0.', 'Bone marrow smears from cases with MDS and non-clonal disease were collected and performed microscopy analysis.', 'Seventy BAL were performed and flow cytometric study was analyzed in 23 of them.', 'The correlation of cytologic and flow cytometric study of BAL with the microbiological findings and the clinical evolution was determined.']


Cluster  322
['To assess the association between lifestyle behaviors and clinical outcomes in patients with IPF.', 'This is a retrospective, observational study of a cohort with ILD who had completed PR.', 'The purpose of this pilot, blinded-assessor randomized trial was to evaluate the effects of LT intensity on walking outcomes in individuals with iSCI.', 'Using a crossover design, ambulatory participants with iSCI >1 year duration performed either high- or low-intensity LT for ≤20 sessions over 4 to 6 weeks.', 'The VAS is valid for assessing change in dyspnoea and fatigue in ILD.', 'Standard PR gives initial benefits in participants with ILD who complete the course, however these are not sustained.', 'A total of 34 IPF patients (median age 68 years) were assessed for daily sitting and weekly walking times using the International Physical Activity Questionnaire by in-person interview at baseline, and they were followed up for up to 40 months.', 'Eighteen patients with IC performed the 6-minute walking test in 2 conditions in random order: GCS or placebo sock.', 'To validate VAS to assess change in dyspnoea, cough and fatigue in ILD, and to define the minimal clinically important difference (MCID) for change in these.', 'GCS does not decrease walking performance and calf muscle oxygenation saturation during 6-minute walk test in patients with IC.']


Cluster  758
['Antimony-unresponsiveness in visceral leishmaniasis is a serious problem numerically , clinically and economically .', 'Leishmaniasis is considered a serious public health problem and the current available therapy has several disadvantages , which makes the search for new therapeutic targets and alternative treatments extremely necessary .', 'Leishmaniasis is a serious health problem that needs a suitable vaccine delivery system to control the disease .', 'Antimony unresponsiveness in mucocutaneous and visceral leishmaniasis is a serious clinical problem .', 'This data proves the ability of this system as a promising DNA vaccine carrier for leishmaniasis to cover the main drawback of naked pDNA delivery that is rapid elimination from the circulation .', 'Leishmaniasis is a complex disease caused by protozoan parasite Leishmania and the treatment remains a serious problem since the available drugs exhibited high toxicity and side effects .', 'Currently , the therapy is toxic , expensive and the resistance has emerged as a serious problem , which has compelled the search for new antileishmanial agents .']


Cluster  1297
['Spinal cord ischemia after treatment of thoracic pathologies remains a devastating problem .', 'Acute spinal cord injury is a serious concern in football , particularly the rugby codes .', 'Thoracolumbar fractures are among the most common types of damages caused to the spinal cord .', 'Spinal injuries represent a serious medical and social problem for society on all continents .', 'Spinal injury is a serious problem and has an associated high mortality and a high complication rate .', 'In this prospective analytical-observational study evaluating the association between ambulatory status\xa0and spinal injury in patients involved in MVCs, we observed that those patients who were nonambulatory were more than two times as likely to have a spinal injury compared to those patients who were ambulatory at the scene.', 'Missed spinal fractures . A serious problem in the patient with multiple injuries .', 'Spine pain is a serious clinical problem of physically active people and sportplayers .']


Cluster  1401
['The principal problem with this paper is that it can not be considered an advance on ( or even an equal of ) the state of the art as the approach it describes makes the same limiting assumptions as approaches proposed 10 years ago .', 'The paper concludes with an analysis of our results , and some discussion of related and future work . vagueness', 'The paper concludes with an analysis of our results , and some discussion of related and future work . vagueness', 'Our series, although limited in size, emphasizes the interest of PDT in this difficult condition even though results may be incomplete.']


Cluster  2380
['Metabolic engineering was then further applied to eliminate a byproduct of the spontaneous conversion of indoxyl to indigo , thereby solving a serious problem with the use of bio-indigo in the final denim dyeing application .', 'To compare the efficacy and safety of double-pass pulsed dye laser (DWL) and single-pass PDL (SWL) in treating virgin port wine stain (PWS).', 'First , these aminoanthraquinones are strong and persistent blue dyes and the administration of lower doses would minimize a potential cosmetic drawback of these compounds .']


Cluster  1553
['Coronary slow flow (CSF) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries without obstructive coronary disease.', 'Our study included 40 patients with CSF and 40 subjects with normal coronary arteries.', 'Using CDI, we observed that early diastolic velocity (E) was significantly lower in patients with CSF, while late diastolic velocity (A), E/A ratio, isovolumic relaxation time, and myocardial performance index (MPI) were significantly higher in CSF patients compared with controls.', 'Left ventricular systolic and diastolic function may be negatively affected by CSF.']


Cluster  1648
['Japanese encephalitis virus ( JEV ) has been a serious public health problem in Bellary district since 1981 .', 'Acute encephalitis syndrome ( AES ) is a serious public health problem , caused mainly by viruses .', 'Encephalitis can cause a severe public health problem .', 'Japanese encephalitis ( JE ) is a serious public health concern with a high mortality rate in many Asian countries .', 'Japanese encephalitis remains a serious health concern in Asian countries and has sporadically affected pediatric travelers .', 'Japanese encephalitis is a devastating disease that causes a frequently fatal encephalitis and is a major health problem throughout much of Asia .']


Cluster  1979
['Barzilay and Lapata -LRB- 2006 -RRB- use it for content aggregation in a generation system . all MFbased methods map words and their context words to two different sets of embeddings , and then employ Singular Value Decomposition ( SVD ) to obtain a low rank approximation of the word-context matrix M', 'The first limitation is , all MFbased methods map words and their context words to two different sets of embeddings , and then employ Singular Value Decomposition ( SVD ) to obtain a low rank approximation of the word-context matrix M', 'Barzilay and Lapata -LRB- 2006 -RRB- use it for content aggregation in a generation system . all MFbased methods map words and their context words to two different sets of embeddings , and then employ Singular Value Decomposition ( SVD ) to obtain a low rank approximation of the word-context matrix M']


Cluster  1903
['Although the presented series is small, it suggests that cystourethroscopy is superior to contrast studies in preoperative illustration of the abnormal anatomy in cases of cloacal malformations.', 'Cloacal malformation is a spectrum of diseases affecting females, resulting in abnormal confluence of the urinary system, genital system, and/or gastrointestinal system.', 'The aim of this study was to compare the accuracy of the contrast study and diagnostic cystourethroscopy in the demonstration of the exact changes in anatomy resulting from urogenital sinus / cloacal abnormalities.']


Cluster  1954
['Profound depression of brain activity due to severe hypercapnia is also seen in infants.', 'Twenty-five infants (21 preterm, 4 full-term) comprising 32 episodes of acute severe hypercapnia were identified.', 'Observational study of full-term and preterm infants with acute severe hypercapnia (identified by arterial blood gas measurements), monitored with aEEG.']


Cluster  1717
['Lymphatic filariasis caused by Wuchereria bancrofti is a serious public health problem in rural communities of Nigeria .', 'Children aged 5-18 years from Odisha, India were screened for W. bancrofti infection and disease.', 'Lymphatic filariasis ( LF ) is a serious vector-borne health problem , and Wuchereria bancrofti ( W.b ) is the major cause of LF worldwide and is focally endemic in Egypt .', 'A significant proportion of a young W. bancrofti infected population exhibited lymphatic pathology which was reversible with annual dosage of DEC and albendazole.']


Cluster  726
['Chronic cough can be a troublesome clinical problem .', 'Asthma is a serious health problem in blacks and is not explained by differences in demographics , severity , or other health conditions .', 'The smoking related respiratory diseases represent a serious medical , social , and economic problem .', 'Lung cancer among blacks is a serious public health problem , with a mortality rate of 119 per 100,000 among black males compared to 81 per 100,000 for white males .', 'Lung diseases remain a serious problem for public health .', 'Overall , a chronic cough is not only a serious health problem , but also a social one .', 'The findings demonstrate smoking as a serious social problem associated with allergic diseases , and a habit that differs between place of residence and work environment .']


Cluster  680
['The infection was controlled in all 25 cases within 2 to 8 days even though , in 11 cases , previous antibiotic therapy had been insufficient , no complementary antibiotic treatment was associated and 8 of the cases with very severe infection were a serious problem to the intensive care unit .', 'The purpose of this study was to explore the efficiency and adverse effects of nebulized amikacin treatment for 2 weeks, administered as intravenous therapy during exacerbation of BE patients infected with P. aeruginosa.', 'Phlebitis is a serious health problem that affects a large proportion of hospitalized patients receiving intravenous therapy .', 'In comparison with patients who underwent FSL, patients treated with FS only had higher incidence of phlebitis within 4\xa0weeks (14.', 'Even though treatment with four antibiotics was used, this "reinforced" therapy achieved suboptimal results.', 'Nebulized amikacin treatment is a safe treatment for exacerbation of BE and significantly increases the bacterial eradication rate of sputum.']


Cluster  572
['If effective control measures are not implemented , precipitous declines in bat populations are likely , particularly in cave-dense regions that constitute the main geographic corridors of the USA , a serious concern for bat conservation .', 'Therefore , rodents should still be a serious concern as reservoirs of emerging viruses .', 'Damage caused by rats is a serious hazard to the environment and crop irrigation', 'The presence of different species of ( primarily insectivorous ) bats in urban areas represents a serious public health problem .', 'In São Paulo city , rodent infestation is considered to be a serious public health problem and is the object of a municipal rodent control programme .', 'Another problem connected with the use of chemosterilants is that , on account of the sexual behaviour and physiology of domestic rodents , it would be necessary to reach nearly 100 % of the population to obtain effective control .', "It is widely recommended to group-house male laboratory mice because they are ' social animals ' , but male mice do not naturally share territories and aggression can be a serious welfare problem ."]


Cluster  2016
['KPC-producing Klebsiella pneumoniae ( KPC-Kp ) represent a serious problem worldwide .', 'The rapid emergence of KPC-producing Klebsiella pneumoniae has become a serious problem in health-care settings , increasing in frequency worldwide .', 'To the best of our knowledge , this is the first report in China on the co-occurrence of a pLVPK-like virulence plasmid and two MDR plasmids in a single ST11 XDR and hypervirulent Klebsiella pneumoniae isolated from patient urine , which is a serious concern for its further spread .']


Cluster  485
['A quasi-experimental pre-post intervention clinical trial was conducted at a specialist travel clinic in Australia.', "Traveller's diarrhoea (TD) is the most common infectious problem for travellers, and we lack effective ways of preventing it, apart from antibiotic prophylaxis", "Traveler 's diarrhea can be a debilitating problem for individuals on international trips .", 'A retrospective cohort, with a nested case-control study of adults who received polymyxin B for more than 48 hours at a tertiary university hospital in Colombia (2011-2015) was performed.', 'The cutaneous ulcer in a patient with a history of international travel poses a vexing diagnostic dilemma for the clinician .', 'Antimicrobial chemoprophylaxis can be used in the rare person from an industrialized area during brief travels to a tropical region who has a serious underlying medical problem , can not exercise care in what is eaten and drunk , and will have the purpose of the trip put at jeopardy should any illness develop ( even that rendered short-term by effective therapy ) .', "Traveller 's diarrhea , though not life-threatening . is often a vexing problem , which impacts overall function of the traveller", 'Sixty patients were randomized to immediate motion (IM) or delayed motion (DM) following TSA.']


Cluster  2391
['12 months of surveillance of breast cancer patients reveals medium-term recovery of the global health status/quality of life and cognitive and psychosocial well-being associated with ECLR.', 'Breast cancer survivors often report a decrease in physical activity levels and quality of life.', 'Patient-reported outcome measures were evaluated by analyzing European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30) in patients with non-metastasized breast cancer who had received either oncological standard therapy alone or in combination with ECLR.', 'Our results showed that mind-body interventions seem to be an interesting psychological approach to improve the well-being of breast cancer patients.', 'Quality of life (QoL) in early breast cancer (BC) treatment may be affected by acute and late toxicities.']


Cluster  2055
['Elevated serum MBL concentrations are associated with injury severity and long-term poor prognosis after aSAH.', 'Serum MBL levels were determined in 132 aSAH patients and 132 controls.', 'Serum MBL levels were significantly higher in patients than in controls.']


Cluster  198
['In human , CE is a serious public health concern in many parts of the world including Jordan .', 'However , evaluation of current studies suggests that EMF may represent a serious source of concern and may be hazardous to living organisms .', 'ECC is a serious public health problem in this population that requires considerable efforts of early detection and treatment along with successful preventive strategies to decrease the same .', 'The results of this study indicate that ECC is a serious problem in Manitoba .', 'These data suggest that cestode zoonoses in this , and possibly other parts of Nepal may be a serious concern for human health .', 'CE is a serious public health concern in many parts of the world , including Pakistan .', 'The effectiveness of 38% SDF in preventing ECC remains uncertain.', 'EDCs pose a serious health concern since they may cause a wide range of health problems , starting from pre-birth till adult lifelong exposure .', 'Human CE is a serious life-threatening neglected zoonotic disease that occurs in both developing and developed countries , and is recognized as a major public health problem .']


Cluster  2111
["The results are almost similar with that of OOV results shown in Table 8 except for Person . a variant of Kipps ' caching cannot be used", "The results are almost similar with that of OOV results shown in Table 8 except for Person . a variant of Kipps ' caching cannot be used"]


Cluster  2068
['I describe in this report a serious shortcoming in analyzing enzymatic reactions when kcat[E]₀/K(m ) is employed and show that k(cat)[E]₀/K(m ) can only be applied under very limited conditions .', 'Racemization is the key step to turn a kinetic resolution ( KR ) , which suffers from the well-known drawback of being limited to a maximum yield of 50 % with high enantiopurity , into a dynamic kinetic resolution ( DKR ) process .', 'The main problem with this kinetic relationship is that it neglects the contribution of important factors operating in actual bioprocess conditions , such as substrate concentrations and product inhibition , leading to unreal expectations on enzyme performance and erroneous selection of the most adequate biocatalyst .', 'Processes catalyzed by enzymes offer numerous advantages over chemical methods although in many occasions the stability of the biocatalysts becomes a serious concern .']


Cluster  1208
['Further , lack of such expensive diagnostic tools in remote areas is a serious concern .', 'CRC is susceptible to screening because it is a serious health problem given its high incidence and its associated high morbidity/mortality .', 'The possibility that the QBC test and minicolumn anion exchange system may go out of production could pose a serious problem for field diagnosis .', 'Currently , there is a lack of low cost and noninvasive screening tests for CRC , becoming a serious health problem .']


Cluster  2070
['Therefore , in the classification phase , we can obtain two prediction values for a test review . it does not measure the quality of the abstracts from which the short answers were extracted', 'Therefore , in the classification phase , we can obtain two prediction values for a test review . it does not measure the quality of the abstracts from which the short answers were extracted', 'A major limitation of the factoid-based evaluation methodology is that it does not measure the quality of the abstracts from which the short answers were extracted']


Cluster  1369
['The human respiratory syncytial virus ( hRSV ) is the main etiologic agent of severe lower respiratory tract infections that affect young children throughout the world , associated with significant morbidity and mortality , becoming a serious public health problem globally .', 'Respiratory syncytial virus ( RSV ) infection is a serious health problem in young children , immunocompromised patients , and the elderly .', 'The highly contagious nature of human respiratory syncytial virus ( HRSV ) and the gravity of its infection in newborns and vulnerable adults pose a serious public health problem .', 'At the start of the 21st century , respiratory syncytial virus ( RSV ) remains a serious global health concern .']


Cluster  1523
['Visceral applications on patients with non-specific LBP gave positive results together with OMT and exercise methods.', "The study's objective was to determine the effect of OMT including visceral applications on the function and quality of life (QoL) in patients with chronic nonspecific LBP.", 'Samples from 22 symptomatic OLP patients from a double-blinded, randomized intervention study were collected over a 1-year course at five visits.', 'The topical application of 2% chamomile gel is an effective treatment for OLP.', 'This double-blind study, randomly divided 60 patients with OLP into two groups, 30 treated with 2% Chamaemelum nobile gel (0.']


Cluster  1062
['The limitation of locating parts of arguments , such as the positions and head words , is that it is only a partial solution to argument labeling in discourse parsing', 'Indeed , recent work in parallel with ours -LRB- Bowman et al. , 2015 -RRB- has shown that recurrent models like LSTMs can discover implicit recursive compositional structure . the system considers coreference only within a sentence and between adjacent sentences', 'Researchers have typically used this data to incorporate a great deal of structural syntactic information in their models ( e.g. Ramshaw , 2001 ) , but the obvious weakness of these approaches is the resulting reliance on manually annotated examples , which are expensive and time-consuming to create', 'This dataset covers a number of chapters from Arthur Conan Doyle short stories and provides full-text annotation of both explicit and implicit semantic roles . the different sentence lengths have not been taken into account', 'This paper proposes a method of selecting important sentences from a text based on the evaluation of the connectivity between sentences by using surface information . since extracted events in test are imperfect , this creates a divergence between training and testing scenarios , which can lead to degraded performance', 'This paper proposes a method of selecting important sentences from a text based on the evaluation of the connectivity between sentences by using surface information . since extracted events in test are imperfect , this creates a divergence between training and testing scenarios , which can lead to degraded performance', 'We evaluate our approach , tracking relevance classification improvement for multi-sentence search task . it is only a partial solution to argument labeling in discourse parsing', 'The major limitation of supervised approaches is that they require meaning annotations for example sentences']


Cluster  1974
['For example , consider the Hebrew roots r. $ . m , p. & . l , p.q.d and the Hebrew patterns hit \\u2751 a \\u2751 e \\u2751 , mi \\u2751 \\u2751 a \\u2751 , ha \\u2751 \\u2751 a \\u2751 a. it re-attaches a single node in every iteration', 'For example , consider the Hebrew roots r. $ . m , p. & . l , p.q.d and the Hebrew patterns hit \\u2751 a \\u2751 e \\u2751 , mi \\u2751 \\u2751 a \\u2751 , ha \\u2751 \\u2751 a \\u2751 a. it re-attaches a single node in every iteration']


Cluster  1176
['All patients (n = 331) had pectoral CIEDs with mean age 73 years, 65% male, ejection fraction 56% for pacemaker subjects, 35% for ICD subjects with 22% pacemaker dependent.', 'The significance of different echocardiographic parameters associated with future ductal patency or HSDA depends on the time of assessment.', 'Exercise echocardiography was performed in 10 047 patients with known or suspected CAD.', 'Patients with DCM who underwent cardiac MRI with baseline and subsequent follow-up echocardiography were included in the study.', 'At the last follow-up visit, transthoracic echocardiography revealed no mitral regurgitation and normal TRANSVALVULAR gradients.', 'sixty patients were included and evaluated with: a) a conventional echoendoscope (7.']


Cluster  1591
['Many people view escape rooms as challenging and fun', 'A serious problem during calculus retrieval is the inability to release a stone from the basket .', 'However , in real situations , the problem of tying', 'A singular problem with many of the laws that are placed on the books is that their intended achievements are frequently largely overcome by unintended results .', 'Indeed , the problem with the transgressive pleasures is that transgression may help to sustain the limits that are supposed to be crossed and deconstructed by a transgressor .']


Cluster  1892
['We aimed at developing a novel risk prediction model for death from cardiovascular disease (CVD) for Chinese individuals, based upon a large cohort from Taiwan.', 'A novel cardiovascular death prediction model with high predictability for Chinese individuals was demonstrated in the present study.', 'A novel CVD death risk prediction model for Chinese individuals was established from this cohort.']


Cluster  1088
['These metabolic syndromes have become a serious problem in developed countries , and there is an increased need for research examining the influence of carbohydrates on animal physiology .', 'One problem associated with feed deprivation is that it promotes catabolism , and young or metabolically compromised mice may have less tolerance .', 'During torpor , metabolic rate is downregulated to fractions of resting metabolic rate and often associated with a severe drop in body temperature that challenges mammalian physiology .', 'It is shown that this problem can be dealt with satisfactorily by introducing other instrumental variables that can be determined experimentally.6 . The final conclusion is that the in vivo enthalpy of hydrolysis of PC is about 10.6 kcal/mole , and is the same in twitches and in tetani .', 'Carriers of the minor allele of rs3123554 variant of CB2R gene loose less body weight during two different hypocaloric diets.']


Cluster  2052
['Any opinions , findings , and conclusions , or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF . limited vowel presentation in this writing system', 'Any opinions , findings , and conclusions , or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF . limited vowel presentation in this writing system', 'Any opinions , findings , and conclusions , or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF . limited vowel presentation in this writing system']


Cluster  1441
['The diagnosis and treatment of congenital esophageal stenosis ( CES ) can be a vexing clinical problem .', 'Surgical treatment of severe peptic esophageal strictures is a serious problem in high-risk cases .', 'Of the 34 patients identified with jackhammer esophagus, most suffered from dysphagia (67.', "Esophageal stenosis , due to its important implications on the patients ' quality of life , poses a serious problem , often difficult to resolve , that requires therapeutical solutions that could irreversibly affect vital conditions and quality of life of those affected .", 'Postanesthetic esophageal dysfunction was a debilitating and costly problem that developed in one dog despite current preventative treatment .', 'Esophageal stenoses , both congenital and acquired , represent a serious problem in childhood due to the deleterious effects , of these anomalies in the patients nutritional state and lifestyle .', 'The treatment of malignant esophageal stenoses is a serious problem which may have a surgical solution at diagnosis in only a selected number of cases .']


Cluster  2247
['Chronic urticaria ( CU ) is a vexing problem and patients of CU suffer from the morbidity that arise from irritable itch and weals and are also subjected to a huge antihistamine pill burden .', 'In this randomized, prospective observer-blinded comparative study, 50 patients with steroid-dependent CRU (6 months of spontaneous urticaria with no response after 3 consecutive months of antihistamines and steroid dependence) were administered either PUVA (group A) or NB-UVB (group B) for 90 days, with a post-treatment follow-up of 90 days.', '[ Chronic urticaria -- still a vexing problem ? Progress in diagnosis and therapy ] .']


Cluster  638
['Similarly , this means that word and all its descendants form a contiguous substring of the sentence . inaccurate constraint estimation', 'catenation of all and thatis some concatenation of all , holds whenever there exists an index such that the following two conditions are satisfied : there is a margin of error in the parallel segment identification and alignment', 'The problem with coding letters by position ( slot-coding ) is that it is difficult to generalize knowledge across positions ; for example , the overlap between CAT and TOMCAT is lost .', 'Similarly , this means that word and all its descendants form a contiguous substring of the sentence . inaccurate constraint estimation', 'Its drawback is it attaches to a character rather than to the location between two adjacent characters', 'This is a strong limitation as no idiom or multi-word expression is allowed to align to a single word on the other side']


Cluster  1459
['To compare running-related pain and injury between minimalist and conventional shoes in trained runners and to investigate interactions between shoe type, body mass, and weekly training distance.', 'Exercise-related or lower-limb overuse injury characterized by pain located between the knee and the ankle that occurs during activity is commonly referred to as shin splint.', 'Twenty-three (13 female, 10 male) asymptomatic runners participated in this cross-sectional experimental trial.', 'We conducted a cross-sectional study of 47 overhead athletes (male,\u200931; female,\u200916) aged 18 to 36 years with SAPS for >3 months.', 'Pain and powerless feeling in the leg during cycling may indicate a serious problem that limits the performance in cyclists .']


Cluster  1489
['The autologous gel outperformed the general biomechanical properties of HA and kept an optimal viscoelastic gel-like behavior for soft tissue augmentation.', 'One limitation with ECM hydrogels is that they tend to have poor mechanical properties compared to native tissues they are trying to replicate .', 'A serious decline in mechanical properties of polysaccharide hydrogels caused by swelling has always been a difficult problem which greatly limited their application especially in the medical field .', 'However , hydrogels have a severe stability problem because of water evaporation , whereas ionogels are not biocompatible or even toxic .', 'Since the cracking of xerogels is a well-known drawback of the sol-gel process , the synthesis presented here can be extended to other applications .', 'A key drawback of hydrogel materials for tissue engineering applications is their characteristic swelling response , which leads to a diminished mechanical performance .']


Cluster  2340
['The MedISAFE-BP study is a prospective, randomized control trial designed to evaluate the impact on blood pressure and medication adherence of an mhealth application (Medisafe).', "The MedISAFE-BP trial is the first study to rigorously evaluate an mhealth application's effect on blood pressure and medication adherence."]


Cluster  2099
['Invasive Aspergillosis ( IA ) is a serious problem among hematological patients and it is associated with high mortality .', 'Immunoprecipitin detection ( IPD ) is the current reference confirmatory technique for anti-Aspergillus antibody detection ; however , the lack of standardization is a critical drawback of this assay .', 'Invasive aspergillosis ( IA ) is a severe life-threatening infection with challenges in therapy .']


Cluster  1012
['The high chroma of cellulosic ethanol production wastewater poses a serious environmental concern ; however , color-causing compounds are still not fully clear .', 'The degradation of textile effluent using microorganisms has been studied extensively , but disposal of generated biomass after dye degradation is a serious problem .', 'In the treatment of synthetic dye wastewater by photosynthetic bacteria under optical irradiation , excessive algal growth and adhesion on the wall of the reactor has been a severe problem .', 'Understanding these processes will provide new tools to assess biodegradation occurrence and , as a final outcome , predict the success of bioremediation thus reducing its uncertainties , the main drawback of this environmental biotechnology .', 'Hydrocarbon contamination is a serious problem that degrades the quality of mangrove ecosystems , and bioremediation using autochthonous bacteria is a promising technology to recover an impacted environment .', "The aim is to provide a comprehensive , critical and chronological view of the scientific works published until now where ' virtuous ' microorganisms are applied on different CH materials , pointing out strength and drawback of the biocleaning treatments ."]


Cluster  2241
['To evaluate the efficacy and safety of autologous platelet-rich plasma in the treatment of female pattern hair loss.', 'Platelet-rich plasma (PRP) has been suggested as a therapeutic intervention for female androgenetic alopecia.', 'To evaluate the therapeutic effects of platelet-rich plasma (PRP) in androgenetic alopecia.']


Cluster  1881
['Physiotherapists are highly consistent using the ABIPA but several items may need revision to improve intra-tester reliability.', 'Determine inter- and intra-tester reliability of physiotherapists using the ABIPA.', 'Across all physiotherapists (n = 30), inter-tester reliability was excellent (α ≥ 0.', 'An observational study using video-recorded assessments of patient performance (n = 7) was undertaken with two cohorts of physiotherapists: those receiving training (n = 23) and those provided with guidelines only (n = 7) to administer the ABIPA.']


Cluster  1546
['13 patients underwent three sessions of a randomized face-split microneedle fractional radiofrequency system (MFRS) treatment of deep dermal and superficial dermal layer.', 'To evaluate skin laxity effects of microneedle fractional radiofrequency induced thermal lesions in different dermal layers.', 'Seventeen subjects were enrolled in the study, and each received three nanofractional radiofrequency (160-pin tip) treatments in the facial area at 3-week intervals.', 'The objective of this prospective pilot clinical study was to evaluate the efficacy of nanofractional radiofrequency in skin resurfacing.', 'Nanofractional radiofrequency is a safe and effective strategy for improving texture, tone, and skin laxity with high patient satisfaction and tolerable safety profile.']


Cluster  1196
['Although there was a clear color mismatch in most patients , none viewed this as a major drawback of the reconstruction .', "Our patients' perception of a night's sleep in the ICU was fair.", 'Analyst bias in color matching is not a serious problem .', 'All anaesthetists recognised perineural spread using 0.', 'However , because the matching theory is well understood , mismatching is not a serious problem in clinical practice and can even be used to increase Peff if necessary .', "The subjects' safety was not compromised during any of the fitting procedures.", 'There were no instances of unplanned removal of the cast by the patient or parent.']


Cluster  1514
['One persistent problem with using therapeutic concentrations of glycyrrhizin ( GZ ) is that , at these high concentrations , it forms a gel in an aqueous solution .', 'To compare the efficacy and safety of 2 HA gels, formulated by 2 different manufacturing processes: XpresHAn Technology (HARRL [with lidocaine]) and Hylacross technology (HAJU-a comparator product without lidocaine).', 'Research results on the efficacy of sunblock sticks in avoiding or reducing Herpes labialis (HL) recurrences are contradictory and has shown mixed results, with some protection reported under experimental conditions that could not be replicated under natural conditions.', 'The purpose of the present work was to carry out an in vivo test on the effectiveness of a protective lip product in preventing recurrent HL in natural conditions during summer.', 'The efficacy of fractional photothermolysis and topical use of calcineurin inhibitors as treatments of idiopathic guttate hypomelanosis (IGH) have been reported.']


Cluster  2228
['The second significant shortcoming which surfaces among ParaMor’s 41 final scheme clusters is that ParaMor currently does not address morphophonology', 'They extract the most content-dense sentences from source articles . ParaMor currently does not address morphophonology', 'They extract the most content-dense sentences from source articles . ParaMor currently does not address morphophonology']


Cluster  1318
['Emergency AS1 calls (999/112) were assessed (n\xa0=\xa01369) and 141 patients (10.', 'Most calls are routine , but one where the caller is reporting a serious infraction can save an organization millions of dollars by forestalling a false claim or allowing for voluntary resolution of a problem . If your company has run a hotline unsuccessfully and earned a poor reputation with employees , outsourcing may be the best option .', 'On call . I hope you can help me understand a troubling and embarrassing problem .', '342 persons were seen at the dermatology department after triage by phone.', 'Telephone calls remain one of the most frequent interruptions in radiology reporting rooms, despite modern electronic order communication systems.', 'Radiologists and referrers remain over reliant on telephone interruptions for their workflow.']


Cluster  2345
['EMG BF training appeared to be a useful tool to enhance motor function of quadriceps femoris in patients with incomplete SCI.', 'The aim of the study was to investigate the therapeutic effect of EMG BF training on motor function of quadriceps femoris in patients with incomplete SCI.', 'Thirty-three incomplete paraplegic patients with quadriceps femoris strength ranging grade 1 to grade 3 less than 6 months post-injury were enrolled.']


Cluster  164
['Juvenile homicide remains a serious problem in the U.S. , despite recent decreases in the juvenile arrest rate for murder .', 'Elder abuse is a preventable problem .', 'Juvenile crime is a serious problem for which treatment approach has been found to be reliably effective .', 'We conclude that incarceration is a preventable problem .', 'Juvenile delinquency is a serious and common problem .', 'Murders committed by juveniles remain a serious concern in the United States .']


Cluster  2204
['The groups were homogeneous for sex (p=0.', 'The 2 randomized groups were homogeneous.', 'The RGV and pH were similar for all groups (P = 0.']


Cluster  2370
['Ebola is a deadly virus that has recently emerged as an enormous public health concern which causes dangerous illness with high fatality rates of 90 \xa0 % .', 'Ebola virus disease is a serious global health concern given its periodic occurrence , high lethality , and the lack of approved therapeutics .', 'Human outbreaks of Ebola virus ( EBOV ) are a serious human health concern in Central Africa .']


Cluster  2292
['However , heterogeneous density of rain gauge coverage , especially the sparse coverage over tropical continents , remains a serious concern .', 'However , foggy and cloudy conditions might pose a serious problem for a wide adoption of their use .', 'However , whether they provide acceptable peak shapes in SFC conditions is a serious concern for them to find applicability .']


Cluster  2342
["Efficacy of both treatments was similar in reducing crow's feet wrinkles depth (STm -7.", 'Adhesive pads should reduce the action of the local muscle contraction on the skin leading to a decrease in the depth of existing wrinkles and the formation of new dynamic wrinkles.', "The use of topical adhesive pads improves wrinkles in the crow's feet area in the first hour after use.", 'This study aims at assessing the antiwrinkles action of adhesive pads during time, and the temporary improvement of facial skin appearance by reducing the vision of linear wrinkles and improving skin elasticity.']


Cluster  616
["There were significant differences between experiment group 1 and experiment group 2's pre-test and post-test scores on moral reasoning (p ≤ 0.", 'The second , implicit , assumption is that research on neuroenhancement does not pose a serious moral problem .', "Both the teaching approaches improved the subjects' moral reasoning; however, Socratic questioning proved more effective than lecturing.", 'This study was conducted to evaluate the impacts of Socratic questioning on the moral reasoning of the nursing students.', 'Moral reasoning and its association with various types of behavior have been the subject of many studies in Psychology']


Cluster  2320
['A superotemporally located yellowish, very soft, freely mobile subconjunctival protrusion developed unilaterally in two and bilaterally in four patients with TAO (incidence 3.', 'Observational study of six patients presenting with a subconjunctival protrusion under the lateral canthus in a series of 198 consecutive cases with TAO examined at a tertiary care referral center.']


Cluster  2307
['We employ a very simple method of text containment to build keyphrase hierarchies from ABBREVCORPUS . these models have not been scrutinized using standard NLP evaluations', 'We employ a very simple method of text containment to build keyphrase hierarchies from ABBREVCORPUS . these models have not been scrutinized using standard NLP evaluations']


Cluster  1167
['Students in the experimental class showed significantly higher improvements in academic performance than those in the control class.', 'Students from the 2014 cohort had higher high school grades than their counterparts.', 'In all school types and grade levels, a highly significant increase in knowledge can be demonstrated.']


Cluster  2378
["CLIP 's inferences on the corpus of political speeches can be browsed at http://www.ark . the considerable delay between user input and wizard response", "CLIP 's inferences on the corpus of political speeches can be browsed at http://www.ark . the considerable delay between user input and wizard response"]


Cluster  2009
['Two new directors were each charged by their institutions to catalyze transformational change in their libraries and to develop dynamic and evolving information ecosystems ready for the information challenges of the future', 'The problem with which human ecology confronts medical librarians is that of inherent complexity combined with vagueness of definition and thought , associated with the risk of dispersing effort and funds ineffectually and too widely .', 'The purpose of this study was to identify the common elements for new faculty orientation (NFO) programs and then replicate two previous studies regarding NFO offerings and needs']


Cluster  1738
['On the back of this we propose a relation based way of performing Argumentation Mining . it limits us to using a single source language', 'On the back of this we propose a relation based way of performing Argumentation Mining . it limits us to using a single source language', 'On the back of this we propose a relation based way of performing Argumentation Mining . it limits us to using a single source language']


Cluster  1248
['Enterovirus 71 ( EV71 ) and Coxsackievirus A16 ( CVA16 ) , as the main agents causing hand , foot and mouth disease ( HFMD ) , have become a serious public health concern in the Asia-Pacific region .', 'The re-emergence of C4 after causing a severe HFMD outbreak with \u2009 > \u2009 200 deaths in 2011 - 12 among susceptible young children raises concern of another impending severe outbreak .', 'The frequent HFMD outbreaks have become a serious public health problem .', 'Emerging epidemics of hand-foot-and-mouth disease ( HFMD ) associated with enterovirus 71 ( EV71 ) has become a serious concern in mainland China .', 'Hand , foot and mouth disease ( HFMD ) is a serious infectious disease , which has become a public health problem .', 'The frequent occurrence of HFMD outbreaks has become a serious public health problem in Asia .', 'Hand , foot , and mouth disease(HFMD)is caused by mainly enterovirus 71(EV-A71)and coxsackievirus A16(CV-A16),and is a serious healthcare problem worldwide .', 'Epidemics of hand , foot and mouth disease ( HFMD ) among children in East Asia have been a serious annual public health problem .', 'Hand , foot and mouth disease ( HFMD ) is a serious public health problem .']


Cluster  2329
['In Study 1, the authors employed a modified independent cue test-to provide as clean a measure of inhibitory functioning as possible-and examined whether there were significant differences in inhibitory effectiveness between younger-old (60-64\xa0years), old (65-69\xa0years), and older-old (70-74\xa0years) adults.', 'The findings suggest that inhibitory functioning remains intact in older adults under the age of 70\xa0years.', 'In Study 1, both younger-old (60-64\xa0years) and old (65-69\xa0years) adults demonstrated RIF on the modified independent cue test but older-old (70-74\xa0years) adults did not.']


Cluster  2366
['With the MTL-based joint tuning , general knowledge can be better learned by the generaldomain models , while domain knowledge can be better exploited by the in-domain models as well . it is completely unsupervised and therefore does not take advantage of the training set provided by the task organizers', 'With the MTL-based joint tuning , general knowledge can be better learned by the generaldomain models , while domain knowledge can be better exploited by the in-domain models as well . it is completely unsupervised and therefore does not take advantage of the training set provided by the task organizers', 'With the MTL-based joint tuning , general knowledge can be better learned by the generaldomain models , while domain knowledge can be better exploited by the in-domain models as well . it is completely unsupervised and therefore does not take advantage of the training set provided by the task organizers']


Cluster  1764
['Castor oil is effective for labor induction, in post-date multiparous women in outpatient settings.', 'Eighty-one women with a low-risk post-date singleton pregnancy with a Bishop score≤7, without effective uterine contractions were randomized to the intervention, 60ml of castor oil, or the control, 60ml of sun-flower oil.', 'Efficacy of castor oil as an agent for the induction of labor, for post-date pregnancies in outpatient settings.']


Cluster  123
['QoL scores of physical and functional domains as well as self-reported anaemia-related symptoms correlated well with haemoglobin level in chemotherapy-treated cancer patients.', 'These results confirm the statistical validity of the QLQ-H & N35 questionnaire, specifically for patients with head and neck cancer in Chile.', 'To statistically validate the QLQ-H & N35 questionnaire in patients with head and neck cancer.', 'The primary objective of this feasibility study was to identify quality of life (QoL) scores and symptom scales as tools for measuring patient-reported outcomes (PRO) associated with haemoglobin level in chemotherapy-treated cancer patients.']


Cluster  2062
['Computed tomography (CT) derived Haller Index (HI) remains the standard for quantifying severity in patient with pectus excavatum (PE).', 'Pectus excavatum and carinatum are two of the most commonly observed chest wall deformities in pediatrics', 'From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure.']


Cluster  1743
['Agitation is a vexing problem frequently observed in emergency department acute psychiatric patients , yet no instruments to measure agitation in this setting and population were found upon review of the literature .', 'Treatment of agitation with intramuscular injections of psychotropics was in general effective in this non-selected, highly agitated psychiatric population, and injections were well tolerated.', 'To evaluate the effect of intramuscular treatment with psychotropics on agitation in a non-selected acute psychiatric population.']


Cluster  2113
['Pancreatitis caused by activation of digestive zymogens in the exocrine pancreas is a serious chronic health problem in alcoholic patients .', 'Alcoholic pancreatitis is a serious medical concern worldwide and remains to be one of the common causes of pancreatic disease .', 'A high incidence of insulin-dependent diabetes remains the main drawback of pancreatic resection , a problem often difficult to manage in the alcoholic .']


Cluster  1584
['This controlled trial with II-1 evidence compared the safety and efficacy of the new laparoscopic-assisted combined hysterectomy (LACH) with the standard surgical technique laparoscopic-assisted vaginal hysterectomy (LAVH) in general and in patients displaying risk factors (large uterus, vaginal nulliparity, prior caesarean section).', 'In Australia, gynaecologists continue to investigate women with abnormal bleeding and suspected intrauterine pathology with inpatient hysteroscopy despite some evidence in the literature that that there is no difference in safety and outcome when compared to an outpatient procedure.', 'From June 2007 to September 2008, 101 patients underwent a hysterectomy at the Clinic of Gynaecology, Obstetrics and Gynaecological Oncology at the Pius Hospital, University Hospital for Gynaecology in Oldenburg.', 'This prospective study assessed the safety, effectiveness and acceptability of outpatient hysteroscopy over 11 years at a tertiary hospital in Australia.', 'Outpatient hysteroscopy was demonstrated to be safe, effective and acceptable to women.']


Cluster  2372
['Nefopam is a non-opioid, non-steroidal, central analgesic thought to act via multiple mechanisms including potent inhibition of serotonin-norepinephrine reuptake and modulation of voltage-sensitive calcium and sodium channels.', 'Nefopam does not appear to delay the onset of lactation or present any clear risk to the newborn.', 'Seventy-two women, scheduled to undergo a caesarean delivery under spinal anaesthesia and wanting to breastfeed, were randomised to one of two groups: nefopam (20mg, six hourly) or paracetamol (1g, six hourly).']


Cluster  1902
['The hearer presupposes that the event e actually took place at some time in the past . the increase of its size with the increase of the text or the n-gram length', 'The hearer presupposes that the event e actually took place at some time in the past . the increase of its size with the increase of the text or the n-gram length']


Cluster  2142
['Individuals with Williams syndrome (WS) are hypersocial; yet, they experience social difficulties and trouble with relationships.', 'Temper outbursts are a severe problem for people with Prader-Willi Syndrome ( PWS ) .', 'This randomized, double-blind, placebo-controlled study suggests that intranasal oxytocin administration has beneficial effects on social behaviour and food-related behaviour in children with PWS younger than 11 years of age, but not in those older than 11 years of age.', 'Eleven children with PWS (11.']


Cluster  1238
['Our series confirms that sinus-induced intracranial sepsis is a serious problem needing early diagnosis and aggressive treatment .', 'We conclude that purulent sinusitis represents a serious and often occult problem in already critically ill patients with multiple potential sources of sepsis .', 'However intracranial complications of sinusitis are rare , but they are still a serious problem that results in high mortality .', 'However intracranial complications of sinusitis are rare , but they are still a serious problem that results in high mortality .']


Cluster  2157
['During his career , Philippe Blache has focused on Natural Language Processing and Formal Linguistics , with a special interest in spoken language analysis . OSN data come with no annotations , and it would be impossible to manually annotate the data for a quantitative analysis of self-disclosure', 'During his career , Philippe Blache has focused on Natural Language Processing and Formal Linguistics , with a special interest in spoken language analysis . OSN data come with no annotations , and it would be impossible to manually annotate the data for a quantitative analysis of self-disclosure']


Cluster  2189
['Rising trends of EKPE were noted in major centres in Australia.', 'EKPE is an emerging condition in Australia.']


Cluster  2061
['Cricoid fracture is a serious concern for balloon dilatation in airway stenosis .', 'Cricothyrotomy is the ultimate option for a patient with a life-threatening airway problem .', "Endoscopic balloon dilatation (EBD) is an alternative to surgery for strictures in patients with Crohn's disease (CD).", 'Tip of novel balloon catheters is only 3\u2009Fr and tapered, and the catheters also show favorable push ability.', 'This study is the first to demonstrate 12-month efficacy and performance outcomes of the Elipse Balloon.']


Cluster  1419
["Marek 's disease ( MD ) remains a serious problem in the production of poultry .", "Marek 's disease virus ( MDV ) is a serious concern for poultry production and represents a unique herpesvirus model .", "Marek 's disease has brought enormous loss in chicken production worldwide and the increasing virulence of Marek 's disease virus ( MDV ) became a severe problem ."]


Cluster  821
['Determining the direction of visual motion poses a serious problem for any visual system , given the inherent ambiguities .', 'The lack of robustness in CACD methods against noise is a serious concern since even the presence of small noise levels may degrade the performance of cataract detection .', 'The benefit of this approach is that the distribution of landing sites of this saccade can be modeled using standard statistical tools ; the drawback is that information about eye movement events following this first regressive saccade is lost', 'The application to the problem of an early detection of glaucoma , a severe eye disease with low prevalence , based on topographical measurements of the eye background faces specific challenges .', 'Fast and accurate mapping and localization of the retinal vasculature is critical to increasing the effectiveness and clinical utility of robot-assisted intraocular microsurgery such as laser photocoagulation and retinal vessel cannulation', 'A common problem with the technique is that the Doppler angle is not known and several approaches have been realized to obtain absolute velocity and flow data from the retina .']


Cluster  1538
['Although the incidence of HAD has markedly decreased since it has become possible to effectively control viral replication in the blood by administering highly active antiretroviral therapy , a less severe form of HAD , comprising a milder cognitive and motor disorder , is now potentially a serious problem .', 'This study identifies several major factors associated with mortality in patients suffering from HAS.', 'To evaluate the clinical characteristics and factors associated with mortality in patients with HAS.', 'Retrospective study of patients with HAS in a major Spanish Hospital from 2011 to 2015.']


Cluster  2313
['Abnormalities within the insular cortex of the salience and thalamus of the hyperarousal network have been increasingly reported in healthy participants with insomnia symptoms by recent resting-state functional magnetic resonance imaging (rsfMRI) studies.', 'Insomnia is associated with substantial impairment of interhemispheric coordination within the default mode (ACC), salience (insula), hyperarousal (thalamus/posterior insula), and visual (fusiform) networks.']


Cluster  2152
['A fundamental drawback of the Fisher-Rao metric is that it is NOT available in closed-form for the mixture model .', 'A fundamental drawback of the Fisher-Rao metric is that it is not available in closed form for the GMM .']


Cluster  2233
['The most common features of aging in the anterior neck are skin laxity and anterior platysma bands.', 'Of the 25 patients, 76 percent had visible platysma bands on the healthy side, but not on the paralyzed side, of their face.', 'Seventeen of the 18 patients had improvement in the platysmal banding.', 'A prospective study was conducted on 150 consecutive neck-lift patients operated on by the same senior surgeon (M.P.C.) between 2010 and 2014 to evaluate patient satisfaction and recurrence rates of anterior skin laxity and platysma bands.', 'The results of this multicenter study support that RF ablation of the cervical branch of the facial nerve is a novel technique that results in improvement of platysmal banding.', 'Platysma bands are one of the first signs of aging of the neck.']


Cluster  1536
['In developed Western settings, asthma is more prevalent among second-generation compared to first-generation migrants.', 'We assessed the association of parental migrant status with wheezing disorders among children born in Hong Kong, a developed non-Western setting, where many children have migrant parents from mainland China of the same ethnicity.', 'In the unique, non-Western context of Hong Kong, second-generation migrants had higher risk of hospitalization for childhood wheezing disorders compared to the native population, particularly before 6 years of age.', 'We used Cox regression to examine the adjusted associations of parental migrant status with time to first public hospital admission for asthma, bronchitis and bronchiolitis (International Classification of Diseases, Ninth Version Clinical Modification 466, 490 and 493) from 9 days to 12 years in a population-representative birth cohort of 8327 Chinese children in Hong Kong.', 'Having both parents as migrants was associated with higher risk of hospitalization for asthma and other wheezing disorders, compared to both parents being Hong Kong born (hazard ratio 1.']


Cluster  1807
['Proximal humeral fractures in four or even only three parts , with metaphyseal hinge distances of < 8 \xa0 mm , represent a serious and widely debated problem .', 'This study showed MIPO in proximal humerus fractures had similar clinical and radiographic outcomes compared to the open plating.', 'This experience allows to highlight essential features of this new kind of endomedullary humeral nail, by its mechanical properties, in proximal humeral fractures in order to permit an early rehabilitation without creating displaced or consolidation delay.', 'In this prospective, randomized controlled study, 107 patients who had an acute proximal humeral fracture were randomized to either the open plating or MIPO techniques.', 'Percutaneous K-wire fixation is an effective treatment for unstable displaced lateral condylar fractures of the humerus in children.']


Cluster  2028
['To determine how often a second or third diagnosis is present in a patient with dizziness and to establish what are the most common combinations of diagnoses.', 'Patients with dizziness frequently present themselves with >1 type of dizziness caused by 2 or 3 different diseases.', 'Many patients with dizziness complain about >1 type of dizziness and therefore there may be ≥2 coexisting diagnoses.']


Cluster  684
['Of course there are many different reasons why speakers make repairs ; but whatever the reason , speech repairs are a normal occurrence in spoken dialogue . the fusion process is typically fed with transcriptions of entire audio recordings ( lasting up to hours )', 'These distortions are detrimental to speech intelligibility and quality , and also pose a serious problem to many speech-related applications , including automatic speech and speaker recognition .', 'The Lombard effect (LE) is a phenomenon in which speakers adjust their vocal production by raising the volume in noisy environments', 'Of course there are many different reasons why speakers make repairs ; but whatever the reason , speech repairs are a normal occurrence in spoken dialogue . the fusion process is typically fed with transcriptions of entire audio recordings ( lasting up to hours )']


Cluster  2054
['Although tumor necrosis factor (TNF)-α inhibitors are effective in patients with rheumatoid arthritis ( RA ) , an increased risk of infections often becomes a serious problem .', 'A failure to respond to TNF inhibitors remains a serious concern for patients with RA .', 'Examine the response to adalimumab in TNF-antagonist-naïve patients.']


Cluster  2331
['A major drawback of Li-S batteries is a severe capacity fading effect which , to a large extent , stems from the dissolution and diffusion of lithium polysulfides ( LiPS ) that are formed during both charge and discharge cycles .', 'Fast capacity decay is a serious problem in vanadium flow batteries ( VFBs ) .', 'Lithium ( Li ) metal batteries ( LMBs ) offer great opportunity for developing high-energy density energy-storage-systems , but the anodes suffer a severe problem of dendrite growth that hinders the practical applications of LMBs .']


Cluster  1818
['One of the important aims of surgery for moyamoya disease is to establish indirect revascularization.', 'Recurrent hemorrhage is a serious neurosurgical problem in adult moyamoya disease ( MMD ) patients .', 'A total of 24 hemispheric sides of 19 patients with moyamoya disease were included in this study.', 'In moyamoya disease, the MMA could be developed as a pathway for indirect revascularization even after simple preservation, especially in pediatric patients.']


Cluster  2195
['We do not assume that the oracle learns over time and hence the speed of annotation or perhaps the accuracy of annotation increases . inaccurate counts for low-probability cooccurrences', 'We do not assume that the oracle learns over time and hence the speed of annotation or perhaps the accuracy of annotation increases . inaccurate counts for low-probability cooccurrences']


Cluster  426
['io3DF with spine navigation minimized radiation exposure of patients and operating room staff and provided an excellent percutaneous pedicle screw accuracy rate with no permanent complications compared with io3DF alone.', 'Our findings demonstrate the superiority of a PLC for endoscopic simulation, compared with an SCC.', 'The problem with virtual vascular 3D-CT endoscopic images is that endoscopic findings in the vascular wall are incomplete because of the partial volume effect and pulsation of the aneurysm and vascular wall .', 'A three-dimensional plan generated using CT images can demonstrate the drawback of ICRU-38 bladder reference point .', 'Despite the wide applicability and many fascinating aspects of image-guided navigation systems , a major drawback of this technology is they use images , mainly MRI pictures , acquired preoperatively , on which the planning of the operative procedure as well as its intraoperative performance is based .', 'Twelve endovascular clinicians performed the same 2 procedures (catheterization of the left renal artery and left subclavian artery) on PHCM and Simbionix angiomentor virtual reality simulator (SVR).', 'Computerized and customized wafers have lacked to improve the accuracy of maxillary positioning , resulting in a drawback of computer-assisted orthognathic surgery .']


Cluster  1365
['Our evaluation shows that the system performs better than the baseline although the baseline performs surprisingly well . longer sentences', 'Our evaluation shows that the system performs better than the baseline although the baseline performs surprisingly well . longer sentences', 'Our evaluation shows that the system performs better than the baseline although the baseline performs surprisingly well . longer sentences']


Cluster  2358
['Standing laparoscopic castration without orchidectomy has been shown to be a reliable method of castration in animals with abdominal cryptorchidism, but it cannot be recommended as a method of castration in those with inguinal cryptorchidism or normal males.', 'A laparoscopic technique that is combined with an open scrotal incision to remove the descended testis in the standing horse was developed and shown to be a safe and reliable option for the castration of unilateral abdominal cryptorchids.']


Cluster  2258
['To assess the efficacy of incobotulinumtoxinA for treating glabellar frown lines (GFLs) in men.', 'Common concentration and double dilution of intradermal abobotulinum toxin type A (Dysport) injection were effective and safe for facial lifting in Asians.', 'This study compared the efficacy of common concentration vs double dilution of intradermal abobotulinum toxin type A (Dysport) injection for facial lifting in Asians.']


Cluster  1148
['Twelve 5-month-old, purpose-bred kittens.', 'Thirty-one client-owned cats.', 'Dog litter not only damages the esthetic quality of a community but also poses a serious health problem .', 'Overpopulation of cats and dogs is a serious worldwide problem that demands novel , safe and cost-effective solutions .']


Cluster  1246
['Hospital in the United States.', 'University hospital, United Kingdom.', 'University hospital in Montpellier, France.']


Cluster  2025
['This representation includes selectional preferences -LRB- like subj , obj , mod -RRB- exactly parallel to inverse selectional preferences -LRB- subj \\u2212 1 , obj \\u2212 1 , comp \\u2212 1 -RRB- . unknown words', 'This representation includes selectional preferences -LRB- like subj , obj , mod -RRB- exactly parallel to inverse selectional preferences -LRB- subj \\u2212 1 , obj \\u2212 1 , comp \\u2212 1 -RRB- . unknown words']


Cluster  2048
['STEP I handles the words which and who which behave differently when they appear at the beginning of a sentence . ontologies are not standard among systems', 'STEP I handles the words which and who which behave differently when they appear at the beginning of a sentence . ontologies are not standard among systems']


Cluster  901
['Infestation of commercial blueberries by the blueberry maggot , R. mendax , is a serious problem in many areas where blueberries are grown .', 'Rust , caused by Puccinia menthae , is often a serious yield-reducing problem on native and Scotch spearmint in south-central Washington State .', 'It is suggested that some scales of surface texture could be exploited to improve future anti-fouling techniques in geographical areas where Balanus improvisus is a severe fouling problem .', 'Blue stain of this timber is a serious problem for which an integrated control strategy is being developed .']


Cluster  1731
['Crowdsourcing is a distributed problem-solving and production mechanism that leverages the collective intelligence of non-expert individuals and networked communities for specific goals', 'We will now discuss the E/R model we propose as a starting point in the kLogNLP pipeline . the unbalanced knowledge sources shared by human beings and a computer system', 'The bottleneck in Artificial Intelligence is the unbalanced knowledge sources shared by human beings and a computer system', 'We will now discuss the E/R model we propose as a starting point in the kLogNLP pipeline . the unbalanced knowledge sources shared by human beings and a computer system']


Cluster  547
['We approached women who sustained a recognized unintentional dural puncture.', 'The present study showed a statistically significant reduction in postoperative drainage amount between ICD and CNPD groups, and ICD is an effective, convenient, and safe method for routine use in lower lumbar surgery.', 'We included 10 women with unintentional dural punctures in the study.', 'Of 30 patients who underwent ICP monitoring with an intraparenchymal wire, 17 had undergone lumbar puncture within the previous 6 months.', 'Eleven sets of 20\xa0ultrasound-guided epidural punctures were performed with 2D, GPS, and multiplanar ultrasound machines (660\xa0punctures) on a spine phantom using an in-plane approach.', 'Ultrasound not only allows us to better identify anatomical structures before lumbar puncture, but it also allows us to choose a site of puncture different from recommendations.']


Cluster  1988
['This study supports the effectiveness of capromorelin oral solution as an appetite stimulant in dogs.', 'Capromorelin oral solution is an effective treatment for stimulation of appetite in dogs and represents the first ghrelin receptor agonist shown to be effective for this indication.']


Cluster  2002
['Although the response of the adductor pollicis muscle to rocuronium cannot be used to determine the adequate rocuronium dose required for complete block of the thigh muscles, intense blockade, with maintenance of post-tetanic count at ≤\xa01 in the adductor pollicis muscle is essential to prevent the obturator jerk.', 'The ED50 (minimum effective anesthetic volume in 50% of the subjects) needed for a 30% decrease in quadriceps power was 46.', 'The rocuronium dose found adequate for complete block of the thigh muscles was 0.']


Cluster  2153
['Intimate Partner Violence ( IPV ) during pregnancy is a serious public health concern globally .', 'Physical abuse are a serious social problem and an issue of perinatal health .', 'Intimate partner violence ( IPV ) around the time of pregnancy is a serious public health concern and is known to have an adverse effect on perinatal mental health .', 'Approximately 6% ( n = 11,766) of survey respondents reported preconception and/or prenatal intimate partner violence, and 36.']


Cluster  2268
['The clause embedding of the sentence Mr Field has said he will resign if he is not reselected , a move which could divide the party nationally ; nested boxes correspond to nested clauses . downgrading explicit relations to implicit ones by removing the explicit discourse connectives', 'The clause embedding of the sentence Mr Field has said he will resign if he is not reselected , a move which could divide the party nationally ; nested boxes correspond to nested clauses . downgrading explicit relations to implicit ones by removing the explicit discourse connectives']


Cluster  1415
['Bridging the two are genres such as discussion boards , web fora , and mailing lists . they strongly depend on the arbitrarily defined window size parameter and do not penalize all error types equally , e.g. , pk penalizes false negatives more than false positives and wd penalizes false positive and negative boundaries more at the beginning and end of the text ( Lamprier , et al. , 2007 )', 'Bridging the two are genres such as discussion boards , web fora , and mailing lists . they strongly depend on the arbitrarily defined window size parameter and do not penalize all error types equally , e.g. , pk penalizes false negatives more than false positives and wd penalizes false positive and negative boundaries more at the beginning and end of the text ( Lamprier , et al. , 2007 )', 'Bridging the two are genres such as discussion boards , web fora , and mailing lists . they strongly depend on the arbitrarily defined window size parameter and do not penalize all error types equally , e.g. , pk penalizes false negatives more than false positives and wd penalizes false positive and negative boundaries more at the beginning and end of the text ( Lamprier , et al. , 2007 )']


Cluster  1348
['The institute has traditionally offered courses In particular aspects of linguistics which are not readily available to students and faculty on their home campuses . they do not assign semantically equivalent sentences the same semantic representation', 'The institute has traditionally offered courses In particular aspects of linguistics which are not readily available to students and faculty on their home campuses . they do not assign semantically equivalent sentences the same semantic representation', 'The institute has traditionally offered courses In particular aspects of linguistics which are not readily available to students and faculty on their home campuses . they do not assign semantically equivalent sentences the same semantic representation']


Cluster  2389
['In an observation task using a touch panel of a setting requiring environmental improvement, we found no observable differences between the two reflection methods with regard to gaze and judgement in the overall setting.', "To clarify the effects of different methods of reflection on nurses' gaze and judgement in a task using a touch panel, written and oral methods of reflection were compared."]


Cluster  1691
['90 -RSB- have to hold in order to ensure termination . overgeneration', '90 -RSB- have to hold in order to ensure termination . overgeneration']


Cluster  2375
['For instance , the set of category-section pairs for an article about Albert Einstein contains -LRB- Person , Early_life -RRB- , -LRB- Person , Awards -RRB- , and -LRB- Person , Political_views -RRB- as well as several others . exponential explosion', 'For instance , the set of category-section pairs for an article about Albert Einstein contains -LRB- Person , Early_life -RRB- , -LRB- Person , Awards -RRB- , and -LRB- Person , Political_views -RRB- as well as several others . exponential explosion']


Cluster  2130
['Head lice infestation ( HLI ) is a vexing problem for pediatricians and families because lice are becoming resistant to approved antipediculosis agents .', 'A multicentre, randomised, assessor-blind, parallel-group trial (Trial 1) was conducted to compare the safety and efficacy of a head lice treatment containing Australian eucalyptus oil and Leptospermum petersonii (EO/LP solution; applied thrice with 7-day intervals between applications) with a neurotoxic treatment containing pyrethrins and piperonyl butoxide (P/PB mousse; applied twice with a 7-day interval) in children.', 'The efficacy, safety and relative ease of use of the EO/LP solution make it a viable alternative in treating head lice.']


Cluster  2310
['The input of PostGraphe , consists of 3 special annotations followed by the raw data . evaluation is typically slower compared to using an intrinsic metric', 'The input of PostGraphe , consists of 3 special annotations followed by the raw data . evaluation is typically slower compared to using an intrinsic metric']


Cluster  2257
['These examples are taken from the collection of review texts . spurious negative examples', 'These examples are taken from the collection of review texts . spurious negative examples']


Cluster  2181
['A fatal case of thallium toxicity : challenges in management .', "Thallium ( Tl ) contamination caused by the industrial wastewater leakage has become a serious environmental problem due to thallium 's high toxicity ."]


{% endraw %}

Fast Clustering (40k + sentences)

{% raw %}
import time
print("Start clustering")
start_time = time.time()

clusters = util.community_detection(embeddings, min_community_size=25, threshold=0.75)
print("Clustering took {:.2f} sec".format(time.time() - start_time))
Start clustering
Clustering took 2.39 sec
{% endraw %} {% raw %}
clus = {}
for i, cluster in enumerate(clusters):
    print("\nCluster {}, #{} Elements ".format(i+1, len(cluster)))
    cluster["cluster_number " + i] = 
    
    for sentence_id in cluster[0:3]:
        print("\t", sentences[sentence_id])
    print("\t", "...")
    for sentence_id in cluster[-3:]:
        print("\t", sentences[sentence_id])
Cluster 1, #164 Elements 
	 Obesity is a serious public health concern with an increasing prevalence worldwide .
	 Obesity is a serious public health problem that is growing alarmingly worldwide .
	 Obesity is a serious public health problem , the prevalence of which is increasing dramatically all over the world .
	 ...
	 The survey findings suggest the majority of the Australian population recognises obesity to be a serious health problem , and support government regulation of the food environment as a population-level preventative strategy .
	 The global prevalence of obesity poses such a serious concern that the World Health Organization ( WHO ) has described it as a " global epidemic . " Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns , dietary habits , and parental feeding practices are established .
	 Childhood obesity represents a social burden.

Cluster 2, #133 Elements 
	 In recent years , the increasing number of antibiotic-resistant bacteria has become a serious health concern .
	 Recently , the rapid emergence of antibiotic-resistant pathogens has caused a serious health problem .
	 Antibiotic resistance is an increasing phenomenon and has become a serious public health concern .
	 ...
	 Bacterial infection is a serious problem threatening human health .
	 The main consequences of use and abuse of antibiotics is the development and diffusion of antibiotic resistance that has become a serious global problem .
	 Drug resistance is a common phenomenon of pathogens , creating a serious problem of inactivation of drugs and antibiotics resulting in occurrence of diseases .

Cluster 3, #99 Elements 
	 This study was a prospective, randomized, controlled study.
	 This was a prospective, randomized controlled trial.
	 This was a randomized, prospective, investigator-blinded study.
	 ...
	 In this prospective, monocentric, two-armed, non-blinded randomized, controlled clinical trial, a total of 43 participants were included.
	 Pilot observational cohort study.
	 A quantitative cross-sectional study nested within a randomised controlled trial.

Cluster 4, #98 Elements 
	 Drug-resistant tuberculosis is a serious problem throughout the world .
	 Drug resistant tuberculosis is a serious problem in control of tuberculosis .
	 Multi-drug resistant tuberculosis is a serious clinical problem .
	 ...
	 The increasing rate of appearance of multidrug-resistant strains of Mycobacterium tuberculosis ( MDR-TB ) is a serious problem at the present time .
	 The high rates of resistance to ethionamide , capreomycin , and kanamycin show the real burden of drug resistance in the region and pose a serious problem for the treatment of patients with multidrug-resistant tuberculosis .
	 Tuberculosis caused by Mycobacterium tuberculosis ( MTB ) remains a serious global public health concern .

Cluster 5, #96 Elements 
	 Viral hepatitis is a serious public health problem with hepatitis B virus ( HBV ) being one of its principle causes affecting billions of people globally .
	 Hepatitis B virus ( HBV ) infection is a serious global public health problem affecting billions of people globally .
	 Hepatitis B virus ( HBV ) infection is a serious public health problem worldwide .
	 ...
	 HCV ( hepatitis C virus ) infection is a serious health care problem that affects more than 170 million people worldwide .
	 Hepatitis C virus ( HCV ) infection is a serious public health problem .
	 Hepatitis B virus infection poses a serious health problem in Taiwan , and plays an important role in the development of chronic hepatitis , liver cirrhosis and hepatoma ; the latter two are among the 10 leading causes of death in Taiwan .

Cluster 6, #62 Elements 
	 Suicide is a serious public health problem worldwide .
	 Suicide is a serious public health problem around the world .
	 Suicide is a serious social and public health problem .
	 ...
	 Suicidal behaviours are internationally considered as a serious health problem and , consequently , considerable efforts are being made in the search for factors related with this behaviour .
	 Suicide is an under attended public health problem in Bangladesh as there is no central suicide database and no national suicide surveillance system in the country
	 Suicide is a serious public health problem in Mato Grosso do Sul , and has had an alarming and disproportionate impact on the indigenous population for more than a decade .

Cluster 7, #53 Elements 
	 Intimate partner violence constitutes a serious health problem worldwide .
	 Intimate partner violence is a serious global problem that damages the health and prosperity of individuals , their families , community , and society .
	 Intimate partner violence ( IPV ) is a serious public health problem , linked with a number of poor health outcomes .
	 ...
	 Dating violence (DV) is still a global problem of enormous proportions
	 Female same-sex intimate partner violence ( FSSIPV ) is a serious problem that affects the health and safety of lesbian and bisexual women .
	 Intimate partner violence ( IPV ) is a serious public health concern that affects many Latinx couples .

Cluster 8, #51 Elements 
	 Diabetes mellitus ( DM ) is a serious global health problem currently affecting over 450   million people worldwide .
	 Diabetes mellitus ( DM ) is a serious medical problem affecting millions of peoples worldwide , and has a great socio-economic impacts .
	  Diabetes mellitus (DM) is considered to be a significant public health problem globally
	 ...
	 Type 2 diabetes is a serious clinical problem in both India and the UK .
	 Diabetes mellitus ( DM ) is a serious public health problem and can cause long-term damage to the brain , resulting in cognitive impairment in these patients .
	 Diabetes is a serious and chronic problem that can be attributed to the insufficient release of the insulin or when body does not respond to the insulin which is already present .

Cluster 9, #49 Elements 
	 Methicillin-resistant Staphylococcus aureus ( MRSA ) strains are a major cause of hospital-acquired infections and are considered a serious public health concern .
	 Methicillin-resistant Staphylococcus aureus ( MRSA ) isolates is a serious public health problem whose ever-increasing rate is commensurate with the pressure it is exerting on the healthcare system .
	 Methicillin-resistant Staphylococcus aureus ( MRSA ) isolates are a serious public health problem whose ever-increasing rate is commensurate with the pressure it is exerting on the healthcare system .
	 ...
	 Nosocomial methicillin-resistant Staphylococcus aureus ( MRSA ) infection in infants has become a serious concern and a new means of preventing the transmission of MRSA in the community needs to be considered .
	 Methicillin resistance in Staphylococcus aureus and in coagulase-negative staphylococci represents a serious problem both for the microbiologist and the physician .
	 Infections with methicillin-resistant Staphylococcus aureus ( MRSA ) and methicillin-resistant coagulase-negative Staphylococcus ( MR-CNS ) are a serious problem in hospitals because these bacteria produce penicillin-binding protein 2 ' ( PBP2 ' or PBP2a ) , which shows low affinity to β-lactam antibiotics .

Cluster 10, #47 Elements 
	 Because of its high prevalence worldwide , osteoporosis is considered a serious public health concern .
	 The high worldwide prevalence of osteoporosis means it is considered a serious public health concern , possibly leading to physical disability and an increased mortality rate .
	 Osteoporosis is a serious worldwide public health concern .
	 ...
	 It is possible to avoid developing a serious osteoporosis and having bone fracture if we realise the problem at the proper time and take the risk factors into consideration .
	 CONTEXT : Low bone mineral density ( BMD ) is a serious public health problem .
	 It is essential to evaluate osteoporosis risk factors , mainly the modifiable , like the lifestyle , in Mexican women in order to prevent it , since it is a serious public health problem .

Cluster 11, #44 Elements 
	 Leishmaniasis is a serious health problem in various endemic areas .
	 Leishmaniasis remains a serious public health problem in several parts of the developing world .
	 Leishmaniasis is a serious health problem in some parts of the world .
	 ...
	 Human immunodeficiency virus ( HIV ) coinfection with Leishmania infantum or Leishmania donovani , the agents of visceral leishmaniasis ( or kala-azar ) , has become a fatal public health problem in the tropics where kala-azar is endemic .
	 Zoonotic Cutaneous Leishmaniasis ( ZCL ) is still a serious health problem in Iran .
	 Zoonotic Cutaneous Leishmaniasis ( ZCL ) due to Leishmania major ( L. major ) is still a serious public health problem in Tunisia .

Cluster 12, #43 Elements 
	 Malaria remains a serious health problem in many parts of the world .
	 Malaria is still a serious public health problem in some parts of the world .
	 Malaria remains a serious public health problem globally .
	 ...
	 The paper concludes by arguing that malaria in urban India is a serious problem that can not be neglected .
	 Malaria , the most virulent parasitic disease , has become a devastating health problem in tropical and subtropical regions , especially in Africa , due to favorable temperature and rainfall conditions for the development of the causative vector .
	 The results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province , Iran .

Cluster 13, #41 Elements 
	 Substance abuse among young people has become a serious public health problem for years .
	 Substance use disorders among youth remain a serious public health problem .
	 Substance use by adolescents and young adults continues to be a serious problem .
	 ...
	 Underage alcohol drinking is a severe public health problem .
	 Binge drinking of alcohol during adolescence is a serious public health concern with long-term consequences , including increased pain , fear , and anxiety .
	 Drug misuse is a serious public health problem .

Cluster 14, #38 Elements 
	 Air pollution has become a serious public health problem for many cities around the world .
	 Air pollution has become a serious public health problem globally .
	 Urban air pollution is a serious worldwide problem due to its impact on human health .
	 ...
	 Environmental pollution has reached a global echo and represents a serious problem for human health .
	 With the explosive economic development of China over the past few decades , air pollution has become a serious environmental problem and has attracted increasing global concern .
	 Particulate air pollution is a serious problem in Beijing .

Cluster 15, #37 Elements 
	 The pollution of environmental systems with heavy metals is becoming a serious problem worldwide .
	 Environmental pollution by heavy metals has become a serious problem in the world .
	 Pollution of the environment with heavy metals is a serious problem , which is recognized in most countries of the world .
	 ...
	 For this reason , soil metal pollution has become a severe problem in many parts of the world .
	 Environmental pollution by potentially toxic elements ( PTEs ) has become a serious problem with increasing industrialization and the disturbance of natural biogeochemical cycles .
	 The accumulation of heavy metal in the soil is a serious concern for sustainable food production due to their toxic effects on plants and other living things .

Cluster 16, #36 Elements 
	 Influenza is one of the most common human respiratory diseases , and represents a serious public health concern .
	 Influenza is an acute respiratory illness and has become a serious public health problem worldwide .
	 Influenza is a serious public health concern worldwide , as it causes significant morbidity and mortality .
	 ...
	 Influenza is a serious economic concern due to the costly countermeasures it necessitates .
	 Currently , H5N1 influenza viruses remain a serious public health concern in Asia and now in Europe .
	 Seasonal influenza has become a serious public health problem worldwide , and vaccination is recognized as the most effective preventative measure .

Cluster 17, #35 Elements 
	 A total of 106 patients (68F, 38M) with a mean age of 49.
	 In all, 2051 patients [median (range)], aged 41 (1-101) years, 72.
	 Included in this study were 17 patients, 6 women and 11 men, with a mean age of 58 years (19-87).
	 ...
	 Fifty patients aged 25 to 90 years (34 females), who had a mean follow-up of 6,3 years (range 4-14 years), were selected.
	 From 273 eligible patients, we received data from 135 patients, 9 of them died during the follow-up time at the median age of 46years (range 30-64years).
	 In total, 198 patients were randomized and 175 patients completed the trial with a mean age of 49.

Cluster 18, #35 Elements 
	 Falls in older adults are a serious problem for individuals , their families , and the health care system .
	 Falls in older adults are a serious public health problem associated with irreversible health consequences and responsible for a substantial economic burden on health care systems .
	 Falls are a serious health problem in older adults .
	 ...
	 Patient fall has been a severe problem in healthcare facilities around the world due to its prevalence and cost .
	 Falls are a serious problem among older cancer patients .
	 Fall events and their severe consequences represent not only a threatening problem for the affected individual , but also cause a significant burden for health care systems .

Cluster 19, #35 Elements 
	 Dengue virus infections are a serious public health problem in tropical and subtropical areas of the world .
	 Dengue is a serious infectious disease and a growing public health problem in many tropical and sub-tropical countries .
	 Dengue infection poses a serious public health problem in most tropical and subtropical areas .
	 ...
	 Dengue Haemorrhagic Fever ( DHF ) is a serious and often fatal paediatric problem in Myanmar .
	 Dengue fever is a serious concern for Japanese people staying in Southeast Asia .
	 Two flaviviruses , Japanese encephalitis ( JE ) virus and Dengue ( DEN ) virus which have high pathogenicity for humans , continue to pose a serious public health problem in tropical and subtropical countries of the world .

Cluster 20, #33 Elements 
	 Arsenic ( As ) contamination in soil and groundwater has become a serious problem to public health .
	 Arsenic contamination of soil and groundwater is a serious problem worldwide .
	 Arsenic ( As ) contamination of water is a serious problem in developing countries .
	 ...
	 Arsenic concentrations of tubewell water that exceed acceptable limits poses a serious health problem in Bangladesh .
	 The neurotoxicity of arsenic is a serious health problem , especially for children .
	 Arsenic ( As ) in rice grains is a serious food safety concern .

Cluster 21, #32 Elements 
	 Chronic kidney disease ( CKD ) is becoming a serious health problem ; the number of people with impaired renal function is rapidly rising , especially in industrialized countries .
	 Chronic kidney disease ( CKD ) is a serious health problem due to high mortality and morbidity , negative impact on the patients ' quality of life ( QOL ) , high diagnostic and therapeutic cost , and the burden on society .
	 Chronic kidney disease ( CKD ) is a serious health problem worldwide .
	 ...
	 To retard progression of chronic kidney disease (CKD) and reduce end-stage kidney disease, it is important to detect acute kidney function worsening on CKD (AW-CKD) immediately and bring back their kidney functions to baselines by appropriate treatment
	 The progression of chronic kidney disease is accompanied by multi-organ disorders , among which cardiovascular diseases have the status of a serious clinical problem .
	 Chronic kidney disease ( CKD ) represents a serious concern for the Mexican population since the main predisposing diseases ( diabetes , hypertension , etc . ) have a high prevalence in the country .

Cluster 22, #31 Elements 
	 Schistosomiasis , caused mainly by S. mansoni , S. haematobium and S. japonicum , continues to be a serious tropical disease and public health problem resulting in an unacceptably high level of morbidity in countries where it is endemic .
	 The inherent morbidity and mortality caused by schistosomiasis is a serious public health problem in developing countries .
	 In spite of numerous efforts towards the control of its transmission , schistosomiasis still remains an important parasitic disease and represents a serious public health concern and a major economical problem in a lot of developing countries .
	 ...
	 Manson 's schistosomiasis continues to be a severe public health problem in Brazil , where thousands of people live under the risk of contracting this parasitosis .
	 Urinary schistosomosis is a serious public health problem prevalent in low-income rural regions of sub-Saharan Africa , including coastal part of Kenya .
	 Schistosoma japonicum is one of the three major blood fluke species , the etiological agents of schistosomiasis which remains a serious public health problem with an estimated 200 million people infected in 76 countries .

Cluster 23, #31 Elements 
	 Tobacco smoking is a serious health problem worldwide and a leading cause of mortality .
	 Tobacco smoking is a serious health and social problem .
	 Smoking is a serious public health problem and an important risk factor of many diseases .
	 ...
	 Altogether this study emphasizes the importance of active smoking as a serious public health problem particularly for children and women .
	 Even though it is diminishing in Europe , smoking is still a serious health problem .
	 The smoking related respiratory diseases represent a serious medical , social , and economic problem .

Cluster 24, #30 Elements 
	 Sepsis is a serious and growing health problem among patients admitted to intensive care units .
	 Sepsis is not only a threat to the health of individual patients but also presents a serious epidemiological problem .
	 Sepsis remains a serious clinical problem despite intense efforts to improve survival .
	 ...
	 We are interested in how and why anaesthetics increase infections in intensive care patients ; a serious problem as more than 50 % of patients with severe sepsis will die .
	 Sepsis and septic shock are a serious problem , particularly in the geriatric population .
	 Neonatal late-onset sepsis ( LOS ) is a serious problem in neonatal intensive care .

Cluster 25, #30 Elements 
	 Prescription opioid misuse and abuse is a serious public health concern that can lead to overdose , addiction , and death .
	 Prescription opioid abuse and addiction , along with consequences such as overdose death and increasing transition to heroin use , constitute a devastating public health problem in the United States .
	 Prescription opioid abuse and misuse are a serious problem in the U.S. today .
	 ...
	 Overdose is a serious problem as for people addicted to opioid drug injections ( ODI ) as well as for the community in general .
	 Frequent use of opioid analgesics with other DIMs is a serious problem for drivers and increases the risk of accidents .
	 The misuse of prescription drugs is a serious public health problem .

Cluster 26, #29 Elements 
	 Child abuse is a serious social health problem all over the world with important adverse effects .
	 Child abuse is a serious health problem , which threatens children and has a wide reaching effect on family and society .
	 Child abuse is a serious public health problem and affects the victims ' physical and mental health and development .
	 ...
	 Child sexual abuse ( CSA ) is a serious problem not only in the community but also in institutional settings such as youth-serving organizations , churches , and schools .
	 The under-reporting of child sexual abuse by victims is a serious problem that may prolong the suffering of victims and leave perpetrators free to continue offending .
	 Physical abuse of children is a severe social problem and is usually identified by the presence of bruises of various ages .

Cluster 27, #29 Elements 
	 It represents a serious problem for public health .
	 It represents a serious global public health problem .
	 It has become a serious public health concern , threatening people 's health .
	 ...
	 It is a challenge to physicians , a serious problem to patients and a human and financial loss to the community .
	 It is considered a serious public health problem mainly in tropical and subtropical regions around the world .
	 It is not only a severe health problem in Poland , but as well as in the whole world .

Cluster 28, #28 Elements 
	 Chagas disease is a serious public health problem in Latin America where about ten million individuals show Trypanosoma cruzi infection .
	 Trypanosoma cruzi , responsible for Chagas disease , is a serious public health problem in Latin America with eight million people infected in the world .
	 Chagas disease is a serious public health problem in Ecuador , where nearly 230,000 individuals show Trypanosoma cruzi infection .
	 ...
	 In Venezuela , Chagas disease ( ChD ) is considered a serious health problem , with about 6 million people at risk ; and acute outbreaks due to oral transmission of Chagas Disease ( OChD ) are becoming increasingly important .
	 Chagas disease remains a serious health problem for countries where the most common mode of transmission is infection contracted from the feces of a Triatominae insect vector .
	 Chagas ' disease , caused by the protozoan Trypanosoma cruzi , represents a serious health problem in Latin America , and the available chemotherapy , which is based on 2 nitro-derivatives , is not satisfactory .

Cluster 29, #27 Elements 
	 Breast cancer is a serious health problem worldwide , representing the second cause of death through malignancies among women in developed countries .
	 The high morbidity and mortality of breast cancer among women is a serious problem .
	 Breast cancer represents a serious public health problem worldwide , for its high incidence , morbidity , mortality , and its high cost treatment .
	 ...
	 The already high and still rising mortality rate for breast carcinoma continues to represent a serious problem , especially since neither surgical treatment nor radiotherapy has a significant influence on the prognosis of the disease .
	 Breast cancer is a serious health problem that preferentially metastasizes to bone .
	 Breast cancer poses a serious public health problem , and it is hoped that identification of genetic and environmental factors that contribute to the development of breast cancer will enhance prevention efforts .

Cluster 30, #26 Elements 
	 Asthma is a serious health problem around the world , and affects approximately 10 - 15 % of children and 5 - 10 % of adults .
	 Asthma is a serious health problem , with both mortality and severity increasing in developed countries ( 55 - 57 ) .
	 Asthma is a serious global health problem that affects people of all ages .
	 ...
	 Asthma is a serious problem for low-income preteens living in disadvantaged communities .
	 Forty-eight children with physician-diagnosed asthma (Asthma group) and 31 age-matched normal controls (Control group) were recruited from the Asthma and Allergy Center at Inje University Sanggye Paik Hospital, Seoul, Korea from January 2010 to September of 2012.
	 Asthmatic death in the elderly is a serious problem worldwide .

Cluster 31, #25 Elements 
	 Drug resistance continues to be a serious problem in cancer therapy .
	 However , as in the case of most targeted anti-cancer therapies , the emergence of drug resistance is a serious concern .
	 Resistance of cancer cells to chemotherapeutics and emerging targeted drugs is a devastating problem in the treatment of cancer patients .
	 ...
	 However , acquired resistance to this drug has become a serious problem in the treatment of brain tumor patients .
	 Resistance to chemotherapy remains a serious problem in the successful treatment of gastric and esophageal cancers .
	 However , multidrug resistance ( MDR ) becomes a severe problem after long-term administration of chemotherapy drugs .

Cluster 32, #25 Elements 
	 Anaemia is known to have an impact on child development and mortality and is a severe public health problem in most countries in sub-Saharan Africa .
	 Childhood anaemia is considered a severe public health problem in most countries of sub-Saharan Africa .
	 Anaemia is associated with poor health outcomes and is considered a serious public health problem particularly in low- and middle-income countries .
	 ...
	 Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough ( 63.1 % ) to be described as a severe public health problem .
	 Anemia is a serious public health concern especially in women of reproductive age ( WRA ) as it causes a high burden of morbidity and mortality and persists through intergenerational cycle .
	 Iron deficiency anemia is a severe public health problem in developing countries .

Cluster 33, #25 Elements 
	 Malnutrition is a serious public health problem , particularly in developing countries , linked to a substantial increase in the risk of mortality and morbidity .
	 Malnutrition is a severe problem of public health over all the world , particularly in Latin America .
	 Malnutrition constitutes a serious problem of public health .
	 ...
	 The study concludes that maternal malnutrition is a serious problem in the study area and that there are contextual risk factors that could be addressed to partially tackle the problem .
	 It has been recognized that malnutrition in hospital is a serious problem that may go undetected .
	 This study indicates that undernutrition is a serious problem among rural Malawians aged 45 - 75 years .
{% endraw %}

BERTopic

Visualizations have to be done in Colab (python3.8) On AWS sagemaker Python version is 3.6 and Python3.8 is bad to install because of cuda version...

{% raw %}
from bertopic import BERTopic
topic_model = BERTopic(embedding_model='sentence-transformers/all-mpnet-base-v2', calculate_probabilities=True, verbose=True)
{% endraw %} {% raw %}
topics, probs = topic_model.fit_transform(sentences)
{% endraw %} {% raw %}
topic_model.get_topic_info()
Topic Count Name
0 -1 7142 -1_rrb_lrb_significantly_compared
1 92 524 92_preterm_birth_pregnancy_breastfeeding
2 325 331 325_language_lexical_parse_parsing
3 103 244 103_antibiotic_antibiotics_bacteria_antimicrobial
4 347 228 347_randomized_randomised_placebo_conducted
... ... ... ...
356 94 10 94_coli_escherichia_shiga_toxin
357 352 10 352_55_age_sem_sg
358 283 10 283_foot_knee_brace_braces
359 279 10 279_recruitment_retention_acceptability_interv...
360 119 10 119_probiotic_kefiri_lactose_microbiota

361 rows × 3 columns

{% endraw %} {% raw %}
for t in [1,2,3,4,5]:
    print('\n')
    print(topic_model.get_topic(t))

[('chagas', 0.14040831661877815), ('trypanosoma', 0.05764363064256777), ('trypanosomiasis', 0.051785035239295306), ('african', 0.02603955761615896), ('africa', 0.012058647228130544), ('disease', 0.01141601879882132), ('trypanosomes', 0.010201767290954742), ('trypanosoniasis', 0.010201767290954742), ('trypanosomosis', 0.010201767290954742), ('trypanocidal', 0.010201767290954742)]


[('iodine', 0.20204989105710383), ('idd', 0.09070876944995189), ('deficiency', 0.08313450682477758), ('goiter', 0.04023838967351731), ('iccidd', 0.02501776148382541), ('retardation', 0.01814175388999038), ('biochemical', 0.016544633311393005), ('bangladesh', 0.016237172615316573), ('egypt', 0.015954336192441885), ('saudi', 0.015448679501132085)]


[('toxoplasmosis', 0.12927631099306094), ('toxoplasma', 0.08192420343601008), ('protozoan', 0.051555123096351206), ('toxoplasmic', 0.04594877208174565), ('toxocara', 0.04594877208174565), ('toxocariasis', 0.04594877208174565), ('parasite', 0.04166709361569485), ('encephalitis', 0.031949418491419655), ('ancylostoma', 0.02546772122274313), ('larva', 0.02546772122274313)]


[('harm', 0.07545099515498635), ('suicide', 0.03738660436505054), ('suicidal', 0.03190092443167329), ('behaviours', 0.024785796561352134), ('psychiatric', 0.02312417689407137), ('adolescence', 0.021865166384176692), ('adolescents', 0.02178225956133907), ('behaviors', 0.018190451464244212), ('internalizing', 0.017969610405894898), ('adolescent', 0.01673013637565649)]


[('migraine', 0.1127261365567648), ('headache', 0.08629685981165218), ('headaches', 0.05372020098067405), ('migraines', 0.019093809624402526), ('menstrual', 0.01494943186320704), ('angiography', 0.013276439971023414), ('migraineurs', 0.010582999252500136), ('cephalalgias', 0.010582999252500136), ('catheter', 0.010137958283433944), ('cerebral', 0.00985302501047632)]
{% endraw %} {% raw %}
topic_model.visualize_topics()
{% endraw %} {% raw %}
 
{% endraw %}

Try above after UMAP to reduce dimensionality ... most cluster methods don't handle dimensionality well

{% raw %}
import umap
umap_embeddings = umap.UMAP(n_neighbors=15, 
                            n_components=5, 
                            metric='cosine').fit_transform(embeddings.cpu()) #cuda error
{% endraw %} {% raw %}
!pip uninstall bertopic --yes
Found existing installation: bertopic 0.6.0
Uninstalling bertopic-0.6.0:
  Successfully uninstalled bertopic-0.6.0
{% endraw %} {% raw %}
pip install bertopic==0.9.2
{% endraw %} {% raw %}
pip show bertopic
Name: bertopic
Version: 0.6.0
Summary: BERTopic performs topic Modeling with state-of-the-art transformer models.
Home-page: https://github.com/MaartenGr/BERTopic
Author: Maarten Grootendorst
Author-email: maartengrootendorst@gmail.com
License: UNKNOWN
Location: /home/ec2-user/anaconda3/envs/python3/lib/python3.6/site-packages
Requires: umap-learn, tqdm, numpy, scikit-learn, torch, hdbscan, pandas, sentence-transformers
Required-by: 
Note: you may need to restart the kernel to use updated packages.
{% endraw %}

Top2Vec

{% raw %}
from top2vec import Top2Vec

model = Top2Vec(sentences, embedding_model='universal-sentence-encoder')
2021-11-12 13:03:53,780 - top2vec - INFO - Pre-processing documents for training
2021-11-12 13:03:55,169 - top2vec - INFO - Downloading universal-sentence-encoder model
INFO:absl:Using /tmp/tfhub_modules to cache modules.
INFO:absl:Downloading TF-Hub Module 'https://tfhub.dev/google/universal-sentence-encoder/4'.
INFO:absl:Downloaded https://tfhub.dev/google/universal-sentence-encoder/4, Total size: 987.47MB
INFO:absl:Downloaded TF-Hub Module 'https://tfhub.dev/google/universal-sentence-encoder/4'.
2021-11-12 13:04:09,483 - top2vec - INFO - Creating joint document/word embedding
INFO:top2vec:Creating joint document/word embedding
2021-11-12 13:04:12,226 - top2vec - INFO - Creating lower dimension embedding of documents
INFO:top2vec:Creating lower dimension embedding of documents
2021-11-12 13:04:46,585 - top2vec - INFO - Finding dense areas of documents
INFO:top2vec:Finding dense areas of documents
2021-11-12 13:04:48,311 - top2vec - INFO - Finding topics
INFO:top2vec:Finding topics
{% endraw %} {% raw %}
model.get_num_topics()
90
{% endraw %} {% raw %}
topic_words, word_scores, topic_nums = model.get_topics(77)
{% endraw %} {% raw %}
topic_words
array([['data', 'algorithm', 'structure', ..., 'experimental',
        'language', 'ii'],
       ['placebo', 'cognitive', 'studies', ..., 'randomized',
        'participated', 'mental'],
       ['patients', 'patient', 'studied', ..., 'retrospective',
        'psychological', 'cardiac'],
       ...,
       ['injection', 'viral', 'hepatitis', ..., 'illness', 'protocol',
        'birth'],
       ['asthma', 'lung', 'respiratory', ..., 'conditions',
        'complications', 'causes'],
       ['study', 'studies', 'studied', ..., 'identify', 'chronic',
        'scores']], dtype='<U15')
{% endraw %} {% raw %}
topic_words, word_scores, topic_scores, topic_nums = model.search_topics(keywords=["medicine"], num_topics=5)
{% endraw %} {% raw %}
topic_words
[array(['among', 'of', 'in', 'within', 'on', 'patients', 'over', 'has',
        'at', 'had', 'there', 'an', 'one', 'were', 'while', 'from', 'them',
        'out', 'as', 'have', 'was', 'during', 'given', 'with', 'occurring',
        'by', 'across', 'people', 'individuals', 'persons', 'it', 'some',
        'conducted', 'up', 'having', 'further', 'most', 'even', 'patient',
        'into', 'around', 'through', 'than', 'to', 'about', 'occur', 'the',
        'including', 'are', 'but'], dtype='<U15'),
 array(['drug', 'drugs', 'medication', 'medicine', 'medical', 'alcohol',
        'intervention', 'chronic', 'disorders', 'epidemic', 'inhibitors',
        'disorder', 'ischemia', 'psychiatric', 'prevalence', 'causes',
        'nurses', 'anesthesia', 'depression', 'interventions', 'patients',
        'acid', 'severity', 'syndrome', 'onset', 'drinking', 'physicians',
        'anxiety', 'dysfunction', 'icu', 'hypertension', 'fatal',
        'hepatitis', 'therapy', 'severe', 'smoking', 'liver', 'adverse',
        'antimicrobial', 'debilitating', 'affecting', 'treatment',
        'diagnosed', 'affects', 'clinical', 'death', 'caused', 'pediatric',
        'systemic', 'effects'], dtype='<U15'),
 array(['drug', 'drugs', 'epidemic', 'disorders', 'disorder', 'obesity',
        'intervention', 'medication', 'medical', 'abuse', 'depression',
        'debilitating', 'rehabilitation', 'illness', 'severe',
        'psychiatric', 'chronic', 'alcohol', 'smoking', 'dysfunction',
        'prevalence', 'severity', 'medicine', 'disease', 'consumption',
        'suicide', 'fatal', 'drinking', 'syndrome', 'therapy',
        'hypertension', 'frequent', 'high', 'icu', 'mental', 'injury',
        'diabetes', 'diagnosed', 'problems', 'recently', 'injuries',
        'widespread', 'serious', 'psychological', 'anxiety', 'nurses',
        'concern', 'term', 'systemic', 'hepatitis'], dtype='<U15'),
 array(['placebo', 'patients', 'patient', 'experimental', 'chronic',
        'randomized', 'efficacy', 'mg', 'participated', 'medication',
        'treatment', 'evaluated', 'vitamin', 'psychiatric', 'therapeutic',
        'diagnosed', 'treatments', 'inhibitors', 'effectiveness',
        'toxicity', 'mental', 'studied', 'medicine', 'transfusion',
        'conducted', 'cognitive', 'chemotherapy', 'nurses',
        'interventions', 'examined', 'investigated', 'daily', 'underwent',
        'drug', 'icu', 'recurrent', 'individual', 'clinical', 'matched',
        'therapy', 'clinically', 'applied', 'injection', 'trials',
        'acquired', 'treat', 'presented', 'individuals', 'intervention',
        'assessed'], dtype='<U15'),
 array(['anesthesia', 'injection', 'laparoscopic', 'pain', 'spinal',
        'interventions', 'surgical', 'surgery', 'intervention', 'nerve',
        'nurses', 'efficacy', 'resection', 'patients', 'therapy',
        'placebo', 'effectiveness', 'implant', 'procedure', 'chemotherapy',
        'medicine', 'treatment', 'aureus', 'sepsis', 'dental', 'ischemia',
        'cervical', 'medication', 'oral', 'arterial', 'drug', 'pediatric',
        'debilitating', 'induced', 'posterior', 'antibiotic', 'birth',
        'nursing', 'therapeutic', 'rehabilitation', 'healing', 'cardiac',
        'topical', 'administration', 'evaluated', 'airway', 'prior',
        'procedures', 'effective', 'drugs'], dtype='<U15')]
{% endraw %} {% raw %}
topic_words, word_scores, topic_scores, topic_nums = model.search_topics(keywords=["medicine"], num_topics=5)
for topic in topic_nums:
    model.generate_topic_wordcloud(topic)
{% endraw %}

Since most clustering methods (like LDA) are based on words and word counts ... our dataset (which was done with extracting rules) makes problems:

In topic_num 38 for example, we can see it decides the topic to be: "serious problem" related ...we could filter these topics. There are more topics than rules, so they might just be a small problem (or the rules infiltrate multiple clusters ... since cluster size is set a prior ...)

{% raw %}
documents, document_scores, document_ids = model.search_documents_by_topic(topic_num=38, num_docs=15)
for doc, score, doc_id in zip(documents, document_scores, document_ids):
    print(f"Document: {doc_id}, Score: {score}")
    print("-----------")
    print(doc)
    print("-----------")
    print()
Document: 20636, Score: 0.6788493394851685
-----------
Academic dishonesty has become a serious problem at institutions of higher learning .
-----------

Document: 3087, Score: 0.6698386669158936
-----------
Gap formation has been considered a serious problem by many researchers .
-----------

Document: 18707, Score: 0.6644574999809265
-----------
Attrition of study subjects remains a serious problem in RCTs .
-----------

Document: 11721, Score: 0.6632227897644043
-----------
Coren and Hakstian ( 1990 ) identified a serious methodological problem that arises in auditory research because of interaural correlation .
-----------

Document: 1139, Score: 0.6350462436676025
-----------
Plagiarism is a serious ethical problem among scientific publications .
-----------

Document: 16440, Score: 0.6215311288833618
-----------
Deceit and fraud in medical research is a serious problem for the credibility of published literature .
-----------

Document: 4277, Score: 0.6174214482307434
-----------
The failure to replicate a postulated linkage has become a serious problem in studies on the genetics of complex disorders .
-----------

Document: 17176, Score: 0.6162054538726807
-----------
The rise of plagiarism cases has become a serious concern in the scientific world .
-----------

Document: 314, Score: 0.6101915836334229
-----------
While a lack of research reproducibility has been identified as a serious and prevalent problem in biomedical research and a few other fields , little work has been done to examine the reproducibility of public health research .
-----------

Document: 14106, Score: 0.6091509461402893
-----------
Publication bias is a serious problem requiring further research .
-----------

Document: 18928, Score: 0.6021193265914917
-----------
Insufficient training data is a serious problem in all domains related to bioinformatics .
-----------

Document: 16730, Score: 0.5832703113555908
-----------
The MAUP is a serious problem endemic to analyses of spatially aggregated data in all scientific disciplines .
-----------

Document: 16091, Score: 0.5816615223884583
-----------
Academic drop outs at the university level is a serious problem .
-----------

Document: 1246, Score: 0.5785160064697266
-----------
Because psychoanalysis comprises a theory based on practice , the dearth of clinical material for study , training and research purposes is a serious problem for analysts .
-----------

Document: 20114, Score: 0.5757055282592773
-----------
Obtaining an inadequate sample is a serious problem that can invalidate an entire study .
-----------

{% endraw %} {% raw %}
documents, document_scores, document_ids = model.search_documents_by_topic(topic_num=33, num_docs=5)
for doc, score, doc_id in zip(documents, document_scores, document_ids):
    print(f"Document: {doc_id}, Score: {score}")
    print("-----------")
    print(doc)
    print("-----------")
    print()
Document: 252, Score: 0.7839019298553467
-----------
Twenty-two participants with PD and gait dysfunction were randomized to receive D-ER 10mg twice daily or placebo for 4weeks in a crossover design with a 2-week washout period.
-----------

Document: 8924, Score: 0.7808911800384521
-----------
In this phase IIa, 12-week, randomized, double-blind, three-period, four-treatment, incomplete block crossover trial, BI 671800 was administered either as a single 400-mg dose in the morning (A.M.) or evening (P.M.), or 200 mg twice daily (A.M. and P.M.) versus placebo, together with fluticasone propionate (44 μg, two inhalations twice daily).
-----------

Document: 8638, Score: 0.7768117189407349
-----------
In this double-blind phase 3 study, patients were randomised 3:3:2 to placebo (n=488), baricitinib 4 mg once daily (n=487), or adalimumab 40 mg biweekly (n=330) with background MTX.
-----------

Document: 15773, Score: 0.7747718095779419
-----------
Patients (N = 145) with active RA were randomized to placebo, 1mg, 2mg, 4mg, or 8mg baricitinib for the first 12 weeks.
-----------

Document: 11686, Score: 0.7289563417434692
-----------
Japanese patients (N = 105) were randomized 1:1:1 to omalizumab 300 mg, 150 mg, or placebo by subcutaneous injection every 4 weeks.
-----------

{% endraw %} {% raw %}
documents, document_scores, document_ids = model.search_documents_by_topic(topic_num=31, num_docs=5)
for doc, score, doc_id in zip(documents, document_scores, document_ids):
    print(f"Document: {doc_id}, Score: {score}")
    print("-----------")
    print(doc)
    print("-----------")
    print()
Document: 15921, Score: 0.8620258569717407
-----------
This study is an observational retrospective study.
-----------

Document: 16397, Score: 0.8587977290153503
-----------
This observational study was conducted retrospectively.
-----------

Document: 19824, Score: 0.8554819822311401
-----------
The study was conducted as an observational cross-sectional study.
-----------

Document: 17517, Score: 0.8465601205825806
-----------
The study was an observational, cohort study.
-----------

Document: 10069, Score: 0.843177318572998
-----------
This is a cross-sectional, observational study was conducted.
-----------

{% endraw %} {% raw %}
documents, document_scores, document_ids = model.search_documents_by_keywords(keywords=["diabetes"], num_docs=20)
for doc, score, doc_id in zip(documents, document_scores, document_ids):
    print(f"Document: {doc_id}, Score: {score}")
    print("-----------")
    print(doc)
    print("-----------")
    print()
---------------------------------------------------------------------------
AttributeError                            Traceback (most recent call last)
<ipython-input-19-166731e9217a> in <module>
----> 1 documents, document_scores, document_ids = model.search_documents_by_keywords(keywords=["diabetes"], num_docs=20)
      2 for doc, score, doc_id in zip(documents, document_scores, document_ids):
      3     print(f"Document: {doc_id}, Score: {score}")
      4     print("-----------")
      5     print(doc)

~/anaconda3/envs/JupyterSystemEnv/lib/python3.8/site-packages/torch/nn/modules/module.py in __getattr__(self, name)
   1175             if name in modules:
   1176                 return modules[name]
-> 1177         raise AttributeError("'{}' object has no attribute '{}'".format(
   1178             type(self).__name__, name))
   1179 

AttributeError: 'SentenceTransformer' object has no attribute 'search_documents_by_keywords'
{% endraw %} {% raw %}
words, word_scores = model.similar_words(keywords=["cancer"], keywords_neg=[], num_words=20)
for word, score in zip(words, word_scores):
    print(f"{word} {score}")
carcinoma 0.6299400864524625
chemotherapy 0.5115636699281987
tumors 0.5114513398425593
tumor 0.4922815272044255
illness 0.4841577388566821
disease 0.4621977734891537
colorectal 0.39813017665465344
diabetes 0.3979400605500447
health 0.38523261981957935
depression 0.38502169652389817
death 0.37897240915771246
infection 0.37804526622132173
dysfunction 0.3774285001300006
stress 0.3774044844444605
deaths 0.3714085296895174
fatal 0.3711893020738749
disorder 0.368357163024807
anxiety 0.36508605638353825
traumatic 0.3638851557797911
blood 0.36372690468089247
{% endraw %}

Since we know the different sources in our dataset, let's try the clustering AGAIN but without the algorithmically labeled sentences (data programming)

{% raw %}
cols = [source for source in df["source"].unique() if "..." not in source] #{...} was the give-away for algorithmic generated
cols
['pm_METHODS',
 'acl_cambridge',
 'pm_CONCLUSIONS',
 'pm_OBJECTIVE',
 'labels_oct7',
 'pm_RESULTS',
 'oct3_labels',
 'predicts_acl_pm2500_vocabed',
 'Oct1_clinical_studies_pm']
{% endraw %} {% raw %}
w
{% endraw %} {% raw %}
df2 = df[df['source'].isin(cols)]
sent2 = list(df2["text"])
{% endraw %} {% raw %}
len(sent2)
10631
{% endraw %} {% raw %}
from top2vec import Top2Vec

model2 = Top2Vec(sent2, embedding_model='universal-sentence-encoder')
2021-11-12 14:11:16,316 - top2vec - INFO - Pre-processing documents for training
INFO:top2vec:Pre-processing documents for training
2021-11-12 14:11:17,028 - top2vec - INFO - Downloading universal-sentence-encoder model
INFO:top2vec:Downloading universal-sentence-encoder model
2021-11-12 14:11:21,507 - top2vec - INFO - Creating joint document/word embedding
INFO:top2vec:Creating joint document/word embedding
2021-11-12 14:11:22,904 - top2vec - INFO - Creating lower dimension embedding of documents
INFO:top2vec:Creating lower dimension embedding of documents
2021-11-12 14:11:29,843 - top2vec - INFO - Finding dense areas of documents
INFO:top2vec:Finding dense areas of documents
2021-11-12 14:11:30,302 - top2vec - INFO - Finding topics
INFO:top2vec:Finding topics
{% endraw %} {% raw %}
model2.get_num_topics()
2
{% endraw %} {% raw %}
documents, document_scores, document_ids = model2.search_documents_by_topic(topic_num=0, num_docs=5)
for doc, score, doc_id in zip(documents, document_scores, document_ids):
    print(f"Document: {doc_id}, Score: {score}")
    print("-----------")
    print(doc)
    print("-----------")
    print()
Document: 6912, Score: 0.6765719056129456
-----------
A randomized, double-blind, placebo-controlled, prospective study was performed to assess the effect of dextromethorphan premedication on patients who underwent diagnostic bronchoscopy.
-----------

Document: 1223, Score: 0.6472145318984985
-----------
In the randomized, blinded, sham RIPC (sRIPC) controlled study 51 patients with CHD and GFR less than 80 mL/min/m2, undergoing CAG, were investigated.
-----------

Document: 10351, Score: 0.6471035480499268
-----------
All eligible patients with paraoesophageal lesions on thoracic computed tomography (CT) underwent pulmonologist-performed EUS-B-FNA at two tertiary centres and were included in this prospective observational cohort study.
-----------

Document: 588, Score: 0.6451313495635986
-----------
The aim of this observational cohort study was to investigate the prevalence of depression and cognitive deficits in 104 patients having survived acute TTP.
-----------

Document: 10293, Score: 0.6421284675598145
-----------
This study was performed to compare the preclinical characteristics, clinical efficacy, and safety of a new HA filler, IDHF-001, with Restylane SubQ in the treatment of nasolabial folds (NLFs).
-----------

{% endraw %} {% raw %}
for i,x in range(0,10):
    print(i, x)
{% endraw %}